Archived: NorthStar Home Care Ltd

NorthStar Home Care is a domiciliary care service providing care and support to people living in their own homes. The agency provides help and support to adults with a variety of needs. The service provides a range of care services including; assistance with personal care, preparation of meals, medication administration and companionship. At the time of our inspection there were four people using the service.

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

Some improvements had been made in relation to recruitment, but staff files were still incomplete.

Systems and processes to assess, monitor and improve the quality and safety of the services had improved. However, some key documents held at the service needed to be updated.

Comprehensive assessments of people’s needs were in place. Systems were in place to ensure people who used the service received their medication safely and staff had completed training in medicines administration.

A comprehensive programme of staff training was in place. People who used the service felt they were treated as individuals and respected. People told us the registered manager regularly checked with them to see if they were happy with the care they received.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was requires improvement (published 19 September 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection the service had made improvements and was no longer in breach of Regulations 9, 12 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 12 Registration Regulations 2009 (Schedule 3). However, we found the service had not fully met the requirements made within the warning notices and there were still some improvements required with regard to Regulation 17 and Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

We undertook this targeted inspection to check whether the warning notices we previously served in relation to Regulation 17 and 19 of the of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on warning notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Northstar Home Care is a domiciliary care service providing care and support to people living in their own homes. The agency provides help and support to adults with a variety of needs. The service provides a range of care services including; assistance with personal care, preparation of meals, medication administration and companionship. At the time of our inspection two people were using the service.

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

We found systems were not in place to demonstrate clear management and oversight of the service. A thorough system of auditing and checks were not completed, and records were not always accurately completed and maintained. The registered manager and nominated individual acknowledged that improvements were needed to demonstrate compliance with the regulations.

Safe recruitment processes were not in place to ensure the suitability of those applying to work for the service. A structured programme of induction, training and support needed to be implemented to make sure staff had the knowledge and skills needed to support people safely. The registered manager had relied on personal knowledge of staff rather than evidencing a thorough recruitment and training process had been followed.

Medication plans did not accurately reflect the level of support provided by staff. Appropriate medication training and assessment of staff competency had not been completed to check practice was safe. A review of administration records showed information was not always accurate and complete.

Initial assessments had not been completed by the provider prior to commencing support to ensure the service was able to meet the needs of people.

The Statement of Purpose and policies and procedures needed to be revised and updated. Information should reflect the service provision, so people knew what to expect from the service and staff were guided in how this was to be delivered. We have made a recommendation about the implementation of the Accessible Information Standard (AIS).

Staff rotas were not in place to show how work was co-ordinated in line with people’s contractual agreement.

Care plans provide relevant information about the support people wanted and needed. Areas of risk had been assessed and planned for. Records showed that people had been involved and consulted with about their care and support. 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.

People’s relatives spoke positively about their experiences. They said they had been consulted with and were kept informed. We were told that staff treated their family members in a respectful and dignified manner. Staff were described as “Very mindful and go the extra mile.”

We were told there were no current complaints or safeguarding concerns about people who used the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection - This service was registered with us on 11/02/2019 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the registered manager. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

Enforcement

At this inspection we have identified breaches in relation to initial assessments, staff recruitment, training and development, incomplete and inaccurate records, policies and procedures and quality monitoring systems. A further breach was found in the Care Quality Commission (Registration) Regulations 2009 with regards to the service’s Statement of Purpose.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.