Archived: NurseplusUK

Updated 14 July 2017

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.

The inspection took place on 06 June 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure we are able to speak with people who use the service and the staff who support them. The inspection was carried out by two inspectors.

Before the inspection the provider completed a Provider Information Return (PIR). This 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 sent a questionnaire to people using the service, their relatives and staff and reviewed their responses. We reviewed information we held about the service. We looked at notifications received by the Care Quality Commission (CQC). Notifications are information we receive from the service when a significant event happens, like a death or a serious injury.

We went to the office and reviewed people’s records and a variety of documents. These included people’s care plans and risk assessments, staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys. We spoke with the registered manager, compliance quality manager, coordinators and care staff.

We also visited and talked with people in their own homes. We also spoke with people by telephone to ask their views of the quality of service delivered by Nurse Plus and Carer Plus (UK) Limited.

We last inspected Nurse Plus and Carer Plus (UK) Limited in April 2016 when a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. The service was rated Requires Improvement.

Updated 14 July 2017

The inspection took place at the service’s office on 06 June 2017.

Nurse Plus and Carer Plus (UK) Limited provide care and support to people in their own homes. The service is provided to mainly older people and some younger adults and people who have a learning disability. At the time of the inspection there were approximately 20 people receiving support with their personal care. The service undertakes visits to provide care and support to people in Canterbury, Faversham, Herne Bay, Whitstable and surrounding areas.

There was a registered manager employed at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager was responsible for the day to day control of the service.

People’s medicines were stored safely in their homes. Some people took their medicines independently with no involvement from staff. Other people did need prompting or support and guidance from staff to take their medicines as prescribed by their doctor. Staff were trained to support people with their medicines and senior staff checked they were competent to do so. The guidance for staff about ‘as and when’ medicines was not consistent and we have made a recommendation about this.

People told us they felt safe and trusted the staff that supported them. One person commented, “I feel very safe with the carers”.

Risks to people were identified, monitored and reviewed. Risk assessments gave guidance for staff on how to manage risks. Staff knew how to protect people from the risk of abuse and the action they needed to take to keep people safe. Staff completed regular training about how to keep people safe. The provider had a whistle-blowing policy and staff knew they could take any concerns to other organisations if they had concerns. Staff said they felt confident to whistle blow.

There was sufficient staff employed to give people the care and support that they needed. People told us they received care from regular staff and their calls were usually covered in times of sickness and annual leave.

The provider’s policies were followed when new staff were appointed. Checks, including references and criminal records, were completed to make sure staff were safe to work with people. The registered manager followed the provider’s disciplinary process when required.

People said the service was effective and reliable. The provider had a training programme and staff completed refresher training to make sure they had the skills and knowledge to carry out their roles effectively. Staff attended regular one to one supervision meetings with their line manager and annual appraisals were completed.

People felt informed about, and involved in, their healthcare and were empowered to have as much choice and control as possible. Staff understood the key requirements of the Mental Capacity Act 2005 (MCA) and how it impacted on the people they supported.

People were supported to maintain a balanced diet. Staff supported people to maintain good health. Staff knew people’s routine health needs and kept them under review.

People spoke positively about staff and told us they were kind and caring. People said, “The staff are nice” and “The carers are very kind to me". People were happy with the care and support they received. Staff knew people well.

People were involved in writing and reviewing their care plans. Staff were knowledgeable about people’s likes, dislikes and preferences.

People told us they did not have any complaints but would speak to staff in the office if they had any concerns. They said that staff listened to them and sorted out any issues. Each person had a copy of the complaints procedure in their care plans in their home, and appropriate systems were in place to address any complaints.

There were systems in place to monitor the safety and quality of the service. People were asked for their views and opinions through care plan review visits, spot checks and an annual survey.

People told us they felt the service was well-led. There was an open and transparent culture. Staff said the management were very supportive. Staff were clear about what was expected of them and their roles and responsibilities.

Audits were completed on the quality of the service and actions taken when shortfalls were identified.

Leadership was visible at all levels. There was an open and transparent culture. Staff were able to give honest views and discuss and issues or concerns that they had and the registered manager listened and responded.

Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager submitted notifications to CQC in line with guidance.