Background to this inspection
Updated
23 October 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 was 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 comprehensive inspection took place on 5 and 6 September 2018 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office. The inspection was undertaken by one adult social care inspector and an expert by experience who made phone calls to people who used the service, to seek their opinion's and views. 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 the inspection, we reviewed information we held about the service, including statutory notifications sent to us by the provider about incidents and events that had occurred at the service. Statutory notifications include information about important events, which the provider is required to send us by law. We also looked at a Provider Information Return (PIR). The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.
During the inspection we spoke with 12 people who used the service, including four people in their own homes. We also spoke with two relatives and the friend of one person. We spoke with the registered manager, the new manager, and six staff members.
We looked at six people's care plans and risk assessments. We reviewed three staff personnel files and records relating to recruitment, induction, training and supervision. We looked at people's medication records and audits relating to medication management . We looked at the services' quality assurance systems and audit processes. We looked at health and safety and infection control and how risks were managed.
Updated
23 October 2018
This announced comprehensive inspection took place on 5 and 6 September 2018.
Nurseplus UK is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults. Not everyone using Nurseplus received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of this inspection 45 people were receiving personal care from the service. People who used the service lived in Newton Abbot and the surrounding areas.
The service had a registered manager. The registered manager for the service was also the registered manager of another branch of Nurseplus and was planning to de-register as registered manager of Nurseplus Newton Abbot. A new manager had recently been appointed to manage Nurseplus UK in Newton Abbot. The new manager told us they would be submitting and application to be the registered manager of this service. The new manager took the lead role during the inspection and was supported by the 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.
Our last inspection of this service was on the 21 December 2015 and we rated the service good.
At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People were very positive about the care they received from Nurseplus. People were supported in a kind and compassionate manner. They complimented the caring attitudes of staff. One person told us, “Definitely happy, I’ve been with other care companies for years and with Nurseplus for two years now and I would say they [carers] go over and beyond all the others.”
People felt safe when staff supported them in their own homes. Systems were in place for staff to follow which protected people and kept them safe. People were supported by staff who had received training in and understood how to protect them from any harm and abuse. Staff knew how to, and were confident in, reporting any concerns they may have about a person's safety.
People had received an assessment of their needs to ensure they were suitable for the service. Care plans were used to provide guidance to staff on how to safely meet people's needs. However, some care plans lacked person-centred detail. We made a recommendation to the provider about seeking advice and guidance in developing more person-centred care plans.
Associated risks for staff attending people's homes and for providing care and support to people, were assessed and managed through individual risk assessments. These provided staff with information to help keep both people and themselves safe from avoidable harm with minimal restrictions in place. However, specific risks related to complex health needs were not always in place. We made a recommendation to the provider about this.
Staff had the skills and knowledge to understand and support people's individual needs. These skills were kept up to date through regular training and staff were also supported in their roles from managers and colleagues.
People were supported by staff who were familiar to them. People knew in advance which staff member would attend their care visits which gave them reassurance. Care visits were monitored to make sure staff turned up and stayed for the agreed amount of time. Checks were completed on potential new staff before they started work to make sure they were suitable to support people living in their own homes.
Staff asked people's permission before they helped them with any care or support. People's right to make their own decisions about their own care and treatment was supported by staff.
People told us they had seen recent improvements in how the service was run. One person told us, “I find them very good, they are excellent, and they have improved since {new manager’s name] has taken over.” Another person told us they would definitely recommend Nurseplus to their friends.
The new manager and staff monitored the quality of the service by regularly undertaking a range of regular audits and speaking with people to ensure they were happy with the service they received. Information from feedback and audits were used to aid learning and drive improvement across the service.