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Inspection Summary


Overall summary & rating

Good

Updated 15 November 2017

We undertook an announced inspection of Nissi Care (DCA) on 19 October 2017. We told the registered manager two days before our visit that we would be coming. Nissi Care provides personal care services to people who are living in their own homes. At the time of our inspection 61 people were receiving personal care from the service.

At the previous inspection in October 2016 we found the provider had not taken the necessary actions to ensure that medicines were managed safely. People's Medicine administration records (MAR) did not always contain accurate information relating to the administration requirements of specific medicines. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

People were not always supported in line with the principles of Mental Capacity Act 2005 (MCA) . This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. The provider did not have an effective system in place to monitor the ongoing management of the service. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

At this inspection we found that the registered manager had made significant improvements to address the areas of concern and bring the service up to the required standards. Where people needed support with taking their medicines we saw that medicine records were accurately maintained and up to date. People received their medicines as prescribed.

The registered manager was knowledgeable about MCA and how to ensure the rights of people who lacked capacity were protected. People were supported in line with the principles of MCA.

Regular audits were conducted to monitor the quality of service. These were carried out by the deputy manager and then checked by the registered manager. Audits covered all aspects of care. Information was analysed and action plans created to allow the registered manager to improve the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they were safe. Staff understood their responsibilities to identify and report all concerns in relation to safeguarding people from abuse. Staff had completed safeguarding training. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People's care records contained up to date and accurate information and guidance for staff to mitigate the risks associated with people's care.

People were supported by staff who had the skills and training to carry out their roles and responsibilities. People benefitted from caring relationships with staff who had a caring approach to their work.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staff and the registered manager shared the visions and values of the service.

The service sought people's views and opinions. People and their relatives told us they were confident they would be listened to and action would be taken if they raised a concern.

People were supported to maintain good health. Various health professionals were involved in assessing, planning and evaluating people's care and treatment.

Inspection areas

Safe

Good

Updated 15 November 2017

The service was safe. People told us they felt safe.

Where people were identified as being at risk, assessments were in place.

Staff understood their responsibilities to identify and report all concerns in relation to safeguarding people from abuse.

People received their medicines as prescribed.

Effective

Good

Updated 15 November 2017

The service was effective.

People were supported by staff who had been trained in the MCA and applied it's principles in their work.

Staff had the training, skills and support to meet people�s needs.

The service worked with other health professionals to ensure people's physical health needs were met.

Caring

Good

Updated 15 November 2017

The service was caring.

Staff were kind and respectful and treated people with dignity and respect.

People benefited from caring relationships.

The staff were friendly, polite and compassionate about providing support to people.

Responsive

Good

Updated 15 November 2017

The service was responsive.

People's needs were assessed to ensure they received personalised care.

Staff understood people's needs and preferences.

The service was responsive to peoples changing needs.

Well-led

Good

Updated 15 November 2017

The service was well led.

The registered manager conducted regular audits to monitor the quality of service. Learning from these audits was used to make improvements.

There was a whistle blowing policy in place that was available to staff. Staff knew how to raise concerns.

The service had a culture of openness and honesty.