Background to this inspection
Updated
14 April 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 16 and 21 March 2018. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure staff would be available to speak with us.
The inspection team consisted of one inspector and one 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 this inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make. We also checked other information we held about the service including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with five people receiving care and support and seven family members by telephone. We spoke with a further one person when we visited their home. We spoke with the registered manager, the provider’s auditor, care coordinator, field supervisor and seven care staff. We looked at care records for six people, medicines records and recruitment records for four care staff. We looked at other records in relation to the management of the service, such as health and safety, minutes of staff meetings and quality assurance records.
Updated
14 April 2018
We carried out this announced inspection on the 16 and 21 March 2018.The provider was given 24 hours’ notice because the location provides a domiciliary care service; we needed to be sure that staff would be available to talk with us.
Nurse Plus and Carer Plus (UK) Limited provide personal care and support to people in their own homes. At the time of our inspection the agency was providing a service for 125 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.
We last inspected this service on 14 and 15 August 2014 and we identified one area where improvement was required in respect of staff were not consistently supported with their learning and development. During this inspection, we found that sufficient action had been taken and staff felt supported.
The service had 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.
We received positive feedback from people about the service. All the people who used the service expressed great satisfaction and spoke highly of the care staff. A complaints procedure was in place and people knew how to make a complaint if they needed to.
People felt safe with the service provided by Nurse Plus and Carer Plus (UK) Limited. The risks to people were minimized through risk assessments, staff were aware of how to keep people safe and the information provided staff with clear guidelines to follow. There were plans in place for foreseeable emergencies.
Relevant recruitment checks were conducted before staff started working at Nurse Plus and Carer Plus (UK) Limited to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse.
Staff completed a wide range of training and felt it supported them in their job role. New staff completed an induction before being permitted to work unsupervised. Staff told us they felt supported and received regular supervision and support to discuss areas of development. Staff meetings were held regularly. There were sufficient numbers of staff to maintain the schedule of care visits to meet people’s needs.
People were supported to take their medicines safely from suitably trained staff. Medicines administration records (MAR) confirmed people had received their medicines as prescribed. Staff contacted healthcare professionals promptly when they had concerns about people’s health and wellbeing.
People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.
People were supported with their nutritional needs when required. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.
Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.
Staff felt supported by the registered manager and could visit the office to discuss any concerns. There were systems in place to monitor the quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.