Archived: NurseplusUK

Nurseplus UK is a domiciliary care agency that provides personal care to people living in their own homes in the community. When we inspected they were providing the regulated activity, personal care, to 14 people in the Truro and surrounding areas in Cornwall.

The service provides care to people of all ages with a variety of care needs, such as learning disability, mental health, dementia and sensory needs. Staff supported people to access the local community, do their shopping and prepared meals. Some people received 24 hour care from staff at NurseplusUK to enable them to remain safely in their own homes.

People's experience of using the service:

• People were protected from potential abuse and avoidable harm by staff that had regular safeguarding training and knew about the different types of abuse.

• Staff went above and beyond their roles as carers to ensure people were protected further from risks in their own homes.

• People received outstanding service from Nurseplus UK in relation to the risks they may be exposed to by their accommodation and their method of heating their home.

• Risks to staff working alone late in the evening had been identified.

• The registered manager had provided staff with personal emergency alarms to further protect them when working alone in the community in the evenings.

• There were sufficient numbers of staff to meet people's needs. The provider ensured people had a consistent staff team.

• Medicines were managed safely to ensure people received them safely and in accordance with their health needs and the prescriber's instructions.

• People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs. The provider had a good system to monitor all staff had regular training and refresher training to keep them up to date with best practice. Training methods included online, face to face training and competency assessments.

• Staff provided some shopping services for people. There were procedures in place to ensure that people’s money was protected and managed safely.

• Staff treated people with kindness, compassion and were respectful. Staff interacted well with people and their relatives when providing care.

• One relative told us that she lived out of county and when she visited her relative, she felt ‘she was not needed’ as the carers were so attentive.

• People, and where appropriate their representatives, were involved in decisions made about their care. The management team from Nurseplus UK had visited people prior to them receiving care visits, to discuss their care needs and to develop a care plan. Where necessary, they sought external professional help to support decision-making for people.

• The registered manager was very keen to ensure the service was as responsive to the needs of the people they supported as they could possibly be. The service was outstandingly responsive to people’s needs.

• One person told us they had only the night before, made an out of hours request for a carer to visit them the following morning to give them a shower; this was acted upon swiftly and accommodated in line with the relative’s request.

• Staff knew the people they supported well, several people had had a

relationship with Nurseplus UK for many years. Staff were aware that some people were isolated and lonely alone at home. Staff put forward a suggestion that they set up the ‘Young at heart club’.

• The ‘Young at heart club’ was held in the service offices once a month and people were bought in, by staff, to enjoy tea, cake and the company of others. A variety of information and offers of support and advice would be provided at the events to further enhance their quality of life.

• There was a complaints policy and process in place which people were aware of.

• Staff were provided with specific end of life care training.

• Staff often stayed on at people’s homes supporting the families of people who had died even after their own shift had concluded.

• The registered manager recognised a member of the care staff each month for an award. This was seen as motivational and recognition of staff showing commitment to good care.

• Staff received chocolates, flowers and a certificate to evidence their good work.

• Annually a member of staff was recognised to going above and beyond the call of duty and offered a night in a hotel and a meal as a thank you.

• Everyone we spoke with about Nurseplus UK told us they thought they provided a very good effective service.

More information is in Detailed Findings below

Rating at last inspection: At the last inspection the service was rated Good. The report was published 27 September 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection the service has been found to be Outstanding

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The service provides care and support for people of all ages, in visits at key times of the day to help people get up in the morning, go to bed at night and provide support with personal care, domestic tasks and meals. This includes supporting people with physical disabilities, mental health needs, learning disabilities and dementia care needs.

At the time of our inspection 29 people were receiving a service. These services were funded either privately, through Cornwall Council or NHS funding.

There was a registered manager in post. 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.

We carried out this announced inspection on 24 August 2016. We told the registered manager two days before that we would be coming. This is in line with our current methodology for inspecting domiciliary care services. The service was last inspected in January 2014 and was found to be meeting the regulations at that time.

People we spoke with told us they felt safe using the service and told us, “Marvellous service” and “Excellent staff.”

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. The service was flexible and responded to people’s changing needs.

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People and their relatives spoke well of staff, comments included,“They have never missed me and the visits are at the times I want” and “I am very pleased with the staff, I have no concerns at all.”

Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. Staff were kind and compassionate and treated people with dignity and respect.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

Staff told us there was good communication with the management of the service. Staff said of management, “They (management) are very supportive, you just call the office and something gets done” and “We have regular supervision and meetings it good, I love it here.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. Where the provider had identified areas that required improvement, actions had been promptly taken to improve the quality of the service provided.

Peoples' consent to care had been obtained and documented. We found peoples' views and experiences had been taken into account in the way the service was provided and delivered in relation to their care.

People experienced effective, safe and appropriate care and support that met their needs and protected their rights.

People were protected from the risk of abuse because staff had received appropriate training.

Staff were recruited in a robust and professional manner, supported and trained to meet the needs of people who used the service.

The agency had good quality assurance systems in place.