Archived: 1st Care Nursing Limited

Updated 14 September 2016

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 11, 12 and 24 August 2016 and was an announced inspection. We gave the service 48 hours’ notice of the inspection to ensure management was available to assist us with the inspection. The inspection was completed by one 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.

Before our inspection we reviewed the information we held about the service; this included the last inspection report and statutory notifications. Notifications are changes, events or incidents that the provider is legally obliged to send us. We also reviewed a Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with 14 people who used the service, two relatives, eight members of staff, the domiciliary care manager and the Director of Operations for Active Assistance.

We reviewed a range of documents and records including five people’s care files, seven staff recruitment and support files, training records, arrangements for medication and quality assurance information.

Updated 14 September 2016

The inspection took place on the 11, 12 and 24 August 2016.

1st Care Nursing Ltd is a domiciliary care agency registered to provide personal care and nursing care for adults and children living in their own homes. At the time of our inspection care was being provided to 53 people of whom 17 people were receiving nursing care. The service benefitted from being a subsidiary of the Active Assistance Group which provides services for adults and children with a range of physical disabilities as well as specialised services in spinal cord injury and tetraplegia and other neurological conditions such as multiple sclerosis and cerebral palsy.

The service did not have a registered manager. The domiciliary care manager was in the process of registering with the Care Quality Commission to become a registered 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.

The registered provider did not have robust quality assurance processes in place to ensure the service maintained and improved the quality of care provided. Although staff felt supported by management, some staff told us they had not received regular formal supervision.

There were effective recruitment procedures in place to protect people from the risk of avoidable harm. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Accidents and incidents were recorded and monitored to identify any trends and to mitigate reoccurrence. There were systems in place for receiving, administering and disposing of medicines.

The service provided good care and support to people enabling them to live fulfilled and meaningful lives. Staff were kind and sensitive to people’s needs and ensured people’s privacy and dignity was respected. People had developed positive relationships with staff and were happy with the care and support they received. People were supported by skilled and well trained staff. Staff were trained and understood the principles of the Mental Capacity Act 2005 (MCA).

There was a strong emphasis on person centred care. Care plans were person centred, included people’s individual preferences and needs, and contained clear guidance for staff to follow. Care plans were regularly reviewed and people and, where appropriate, their relatives were involved in the planning of their care.

People were cared for by staff who knew them well. Staff shared information effectively which meant that any changes in people’s needs were responded to appropriately. People were supported to access health care services when required.