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Archived: Nua Healthcare Services (UK) Limited

Office 1, Pondtail Farm, Knepp Castle Estate, West Grinstead, West Sussex, RH13 8LN (01403) 741843

Provided and run by:
Nua Healthcare Services (UK) Limited

All Inspections

7 August 2014

During an inspection in response to concerns

This inspection was carried out by two adult social care inspectors. Prior to our inspection we had received information of concern that people had not received care visits on the days and times agreed. As a result the agency had stopped providing care packages to a number of people due to critical staffing levels. Therefore, the focus of the inspection was to check if the provider had sufficient staff employed to meet people's needs who continued to receive a service. At this inspection the manager informed us that the agency currently provided services to 55 people, nine of whom were currently in hospital, so were not having care visits. We considered our inspection findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on discussions with eight people who received a service from the agency, four relatives, six care workers, two office staff, the manager and two representatives of the provider. We also reviewed records that related to the management of the service. These included staff records, audits, action plans, policies and procedures, complaints, accidents and four people's care and health records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

There was a lack of robust contingency planning in place to manage the shortage of care workers employed at the agency. This meant that people were at risk of not receiving the care and support they needed at the agreed times. A compliance action has been set and the provider must tell us what they are going to do to achieve compliance.

Is the service effective?

The agency had attempted to manage critical staffing levels. This had impacted on the effectiveness of service provision. This meant that at times, people's needs had not been met in full, staff had not been fully supported and systems had not been used in full to monitor the quality of service provided.

Is the service caring?

All but one person that we spoke with said that they were happy with the care workers who visited them. Comments included, 'I have one lady who comes, she is an absolute diamond. Our backgrounds are similar and we get on so well. I requested that she comes every day and so far she has'. Another person said, 'They are very, very nice to me, helpful and cheerful'.

Is the service responsive?

The agency had monitoring systems in place to take action on an individual basis, but there was very little evidence that systems took into account issues at an organisational level. This meant that trends had not been identified and acted upon in a timely manner.

Is the service well-led?

A new manager was in post at the agency and we were informed they were going to submit an application to register with us. Many of the care workers that we spoke with expressed the view that the new manager supported them to undertake their roles and responsibilities. For example, one care worker told us, 'The new manager is brilliant. I can contact him anytime'. Other care workers felt that they did not get the support they needed. As one explained, 'We are supposed to get travelling time between visits, but this does not always happen. The office let us down'. Due to the critical staffing levels that the agency had attempted to manage, the provider had allocated a number of other senior managers to support the running of the agency. We found that the manager and representatives of the provider were open to suggestions and to making improvements. However we found that leadership at the agency was reactive rather than proactive particularly over the last three weeks since they had needed to return care packages to the local authority due to the staffing situation at the agency.

Information about the safety and quality of the service had not been gathered systematically and used to improve outcomes for people. This included a lack of audits and analysis of incidents and events that affected people who used the agency. As a result, monitoring systems did not help ensure the quality of services provided by the agency continually improved. We are following up this with the provider and will report on our actions at a later date.

18 June 2014

During a routine inspection

A single inspector carried out this inspection. As part of our inspection we visited the agency's office. We spoke with three people using the service, one relative and four staff members about their role and responsibilities.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

- Is the service safe?

- Is the service effective?

- Is the service caring?

- Is the service responsive?

- Is the service well-led?

This is a summary of what we found '

Is the service safe?

People told us that they felt their rights and dignity were respected. They said that 'Staff are polite and respectful'. Risk assessments were in place to provide information to staff to help minimise any identified risks. Staff we spoke with told us they felt the risk assessments were informative and provided them with the guidance to help them safely support people. Recruitment practice was safe and ensured that only staff suitable to work with vulnerable people were employed by the service. A relative told us that they had raised concerns with the agency, but didn't feel the concerns had been dealt with. The agency's operations manager was unable to provide any details of an investigation into the concerns. They confirmed that this had not been reported to the local authority under safeguarding procedures. People were not protected from the risk of abuse and neglect because, despite staff being trained to identify and report concerns, concerns were not always reported. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service effective?

People told us that they were happy with the care they received and their needs had been met. Staff we spoke with demonstrated that they had a good understanding of the people's care and support needs and that they knew them well. One person told us. 'The girls that visit are brilliant'. Staff had received training to meet the needs of the people using the service.

Is the service caring?

People we spoke with us told us that they liked the staff. Comments included, 'They are very good', 'Very kind', 'I'm very happy with them' and 'It's really excellent'. When we spoke with staff it was clear they enjoyed their role and they had a good relationship with the people they provided care to. Staff told us, 'I love it' and 'It's brilliant'.

Is the service responsive?

People's needs had been assessed before care had been provided. People we spoke with said that they were involved in their care. We were told that, 'The care workers listen to what I say'.

Is the service well-led?

Staff told us that the service had 'Undergone a lot of changes.' We were told that the agency had expanded and had 'Recently taken over another service'. There was a new operations manager and a new manager in post. The service had introduced systems to monitor the care people received and audits of the process within the agency.

Staff we spoke with were clear about their roles and responsibilities. They told us they felt 'Supported' by the service.