Background to this inspection
Updated
27 April 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by an inspector, an inspection manager, an assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience of older people.
Service and service type:
The service is a domiciliary care agency providing care for people who live in their own homes.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection:
The inspection was announced. We gave the provider a few days’ notice about the inspection site visit. This was because we wanted to make arrangements with the provider to speak to people who use the service. On the 8 March 2019, the expert by experience spoke with people who used the service and their relatives. On 11 March 2019, an inspector and inspection manager visited the office location to speak with the manager and to review care records and policies and procedures. On the 11 March 2019 the assistant inspector made phone calls to staff.
What we did:
We reviewed information we had received about the service since the last inspection in August 2018.
We asked for feedback from the local authority and commissioning teams.
We spoke with the registered manager, care co-ordinator and eight care workers.
We spoke with eight people who used the service and three relatives.
We reviewed parts of three people’s care records and other records and audits relating to the management of the service.
Updated
27 April 2019
About the service: Nightingale Social Care Staffing Agency is a domiciliary care agency. It provides personal care to people in their own flats and houses in the community. At the time of the inspection it was providing personal care to 48 people.
Following the previous inspection in August 2018, a condition was placed on the provider’s registration to ensure all staff were provided with regular support mechanisms. This included checks on their competency, supervision and appraisal. At this inspection we found the service had arranged for staff to receive these checks and support, but they had not consistently been kept up-to-date in line with the provider’s policy. Following the inspection, we removed the condition on the provider’s registration but found a continued breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
People’s experience of using this service:
Whilst the service had introduced systems to assess staff competency, supervision and appraisal these had not been consistently kept up-to-date in line with the provider’s own policy.
People provided positive feedback about the agency. They said staff were kind and caring and treated them well. Most people said they were happy with call times and received appropriate person-centred care and support.
Risks to people’s health and safety were appropriately assessed and mitigated. The service had electronic call monitoring in place to enable office staff to monitor staff in real time, helping to improve the safety of the service.
Staff received a range of training and support. However, the turnover rate was high with some staff saying they did not feel fully supported by management.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service generally supported this practice.
There were enough staff deployed in the right places to ensure people received a reliable service. Safe recruitment procedures were in place to ensure staff were of suitable character to work with vulnerable people.
A range of audits and checks were undertaken to help monitor the quality of the service. Some of these needed to be made more robust to ensure that the service consistently met CQC standards.
We made a recommendation for the provider to put in place a strategy to help support and retain staff.
Rating at last inspection: The service was last rated Requires Improvement in August 2018.
Why we inspected: We inspected Nightingale Social Care Staffing Agency to follow up on the conditions placed on the provider’s registration in December 2018 and to re-rate the service following the pervious inspection in August 2018.
Follow up: We will request an action plan detailing how the provider aims to make improvements to its governance arrangements. We will meet with the provider to discuss the improvements they intend to make to the service. We will re-inspect the service in the future to determine whether improvements have been made.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk