Right Nurse Care Services

Updated 30 March 2023

The Inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post who was also the provider.

Notice of inspection

We gave the service two days’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.

Inspection activity began on 13 March 2023 and ended on 15 March 2023. We visited the office of the service on 14 March 2023.

What we did before the inspection

We reviewed information we held about the service since the last inspection as part of the planning process. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager, 5 staff, 3 healthcare professionals, 5 relatives and received comments from 2 people who were supported by the service. We reviewed the care plans and associated risk assessments for three people, medicine administration records (MARs) and 2 staff recruitment and training records.

Updated 30 March 2023

About the service

Right Nurse Care Services is a domiciliary care agency. The service provides personal care to people living in their own homes. At the time of our inspection there were 5 people using the service. Services are provided throughout Cornwall to people of all ages who have a range of complex needs, including people with a learning disability and autism.

Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided. There were three people who were receiving personal care at the time of this inspection.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting underpinning principles of “Right Support, Right Care, Right Culture.

Right support:

Staff helped to maximise people’s choice, control and independence. People were able to choose how and where they spent their time, and staff supported people to make decisions if required. There were an adequate number of skilled staff to enable people to safely engage in activities of their choice. People were supported to achieve good outcomes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff and the registered manager regularly communicated with people’s relatives. Where restrictions had been required, to keep a person safe, these had been appropriately reported to the appropriate authorities for authorisation.

Right care:

Staff were knowledgeable and cared for the people they supported. They were enthusiastic and able to tell us about people’s recent activities and achievements. Staff knew how to protect people from all forms of abuse and discrimination.

Right culture:

Healthcare professionals were positive about the quality of the support provided to people, the impact upon their well-being and their quality of life. Families were regularly communicated with and updated about their loved ones.

The registered manager was also the provider. They had experienced challenges in being able to recruit staff of the required calibre to meet the complex needs of the people they supported. Staff were recruited safely and told us they felt well supported by the registered manager. Staff and people were able to obtain assistance day or night from a member of the on-call senior management team.

There were effective recording systems in place. All daily records and handover information, for the next shift, were recorded on email and sent via the registered manager to help ensure good communication and that all staff were aware of any changes that may have occurred.

Care plans contained adequate information regarding the person’s needs. The service was working with a consultant to improve the setting of specific goals and outcomes for some people.

There were robust audit and quality assurance systems in place. Staff managed some people’s money. There was a clear system in use where staff accounted for any money spent on behalf of a person.

Medicines were managed safely. All medicines were blister packed by a pharmacist. Staff ensured people always received their medicines as prescribed.

The service had received many compliments regarding the service provided to people.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for the service was good (published 5 October 2018). At this inspection the services rating has remained good.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Right Nurse Care Services on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.