Background to this inspection
Updated
4 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 16,17 and 18 October 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we wanted to be sure that the registered manager and staff were available. The inspection team consisted of two inspectors and an expert-by-experience, making telephone calls to people. 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 for this inspection had experience in care for older people.
Before the inspection, we asked the registered manager to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the agency, what the agency does well and improvements they plan to make. We looked at notifications about important events that had taken place, which the provider is required to tell us by law and the previous inspection report. We used all this information to plan our inspection.
We gained the views of eight people and seven relatives. We visited three people in their own homes. On 18 October an expert by experience telephoned five people and five relatives. We also received feedback from a care manager from the local authority. All feedback was positive about the quality of care and support that people received. We spoke with seven staff, which included two care staff, two care co-ordinators, the quality assurance auditor, the branch manager and the registered manager.
We looked at the provider’s records. These included four people’s care records, which included care plans, risk assessments, daily care records and medicines records. We looked at documentation that related to staff management and recruitment including four staff files. We also looked at a sample of audits, the electronic recording system, staff rotas, minutes of meetings and policies and procedures.
We asked the registered manager to send us information relating to the training of staff and staff newsletter. The information we requested was sent to us in a timely manner.
Updated
4 December 2018
This inspection took place on 16, 17 and 18 October 2018 and was announced. This inspection was the first inspection since the registered office had moved to a new address.
At our last inspection on 23 November 2016 at the previous address the agency was rated as ‘Requires Improvement’ overall with effective, caring and responsive being rated as Good. At this inspection, improvements had been made and the overall rating was ‘Good’.
Nurse Plus and Carer Plus UK Ltd is a domiciliary care agency. It provides nursing and personal care to people living in their own houses and flats in the community. It also provides a service to people who run care homes by supplying nurses and care staff to work at their locations. This inspection report focuses on the way in which care was provided for people in their own homes. At this inspection the agency provided personal care to 20 people.
The agency can provide assistance for adults of all ages including people with a physical disability, sensory needs, mental health issues and a learning disability. It can also provide care for people who live with dementia, misuse drugs and alcohol and people who are receiving palliative care at the end of their lives. At the time of our inspection the service was not providing any nursing care. The agency had its registered office in Maidstone and covered Maidstone and surrounding areas.
There was a registered manager in post that was supported by a branch 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 felt safe and their safety had been maximised with the systems that were in place. There were enough staff to meet people's needs. Staff had been recruited safely. People that displayed behaviour which could challenge themselves or others were appropriately supported.
Risks posed to people had been mitigated. The safety of people and staff in the event if an emergency had been assessed. Accidents and incidents involving people were analysed to reduce the risk of reoccurrence.
Medicines were managed safely and were administered by staff that had been trained and had their competency assessed.
Staff were trained to meet people's needs and were supported in their role by the management team. New staff completed the provider's induction and worked alongside experienced members of staff.
People were supported to maintain their nutrition and hydration. Staff worked in partnership with health care professionals to ensure people remained as healthy as possible.
People's needs were assessed with them at the centre of their care and support. Care plans promoted people's independence and were personalised to meet their needs.
People were encouraged to make their own choices about their lives. 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 supported this practice.
Staff were kind and caring towards people. Staff respected people’s privacy and dignity. Staff knew people well and had knowledge about people’s histories, likes and dislikes. People’s equality, diversity and human rights were promoted and respected.
People were supported to express their views and were involved in the development of the service they received. Complaints were investigated and responded to in line with the providers policy.
Systems were in place to monitor and improve the quality of the service that people received.
It is a legal requirement that a provider’s latest CQC inspection report rating is displayed at the registered office where a rating has been given. This is so that people, visitors and those seeking information about the service can be informed of our judgements. We found the provider had conspicuously displayed their rating on a notice board in the registered office and on their website.