Archived: Community Nursing & Care Agency Limited

Updated 4 October 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 checked 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 17 August 2017 and was announced with 72 hours’ notice. The inspection carried out by one inspector due to the size of the service.

The provider completed a Provider Information Return (PIR) and returned this within the requested timescale. 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. Prior to the inspection we reviewed information we held about the service, we looked at the previous inspection report and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

During the inspection we reviewed people’s records and a variety of documents. These included three people’s care plans and risk assessments, daily records made by staff, medicine records, and training, supervision and appraisal records, two staff recruitment files and visit schedules, accident reports and quality assurance records and survey results.

We spoke with three people who were using the service, who we visited in their own home; we spoke with two relatives, the registered manager, the Chief Executive Officer, two senior staff and four members of staff.

Prior to the inspection we sent out questionnaires. We received feedback via these from six people, two relatives and three health and social care professionals.

Following the inspection we received further feedback from two health and social care professionals who had had contact with the service, which was positive.

Updated 4 October 2017

Care service description

Community Nursing & Care Agency Limited provides care and support to children and adults in their own homes. The service is provided to children as young as four years old; adults and people aged 65+. At the time of this inspection there were 23 people receiving support with their personal care. Community Nursing & Care Agency Limited provides two types of services, supported living and domiciliary care. The majority of people receiving person care had domiciliary care with visits ranging from half an hour up to two hours to support people. One person was receiving personal care under supported living. People receiving supported living can receive up to 24 hours support per day unless they are attending day centre activities.

Rating at last inspection

At the last inspection, the service was rated Good overall and Requires Improvement in the 'Safe' domain

Rating at this inspection

At this inspection we found the service remained good.

Why the service is rated good.

There had been improvements to staffing numbers and risk and medicines management. People received their medicines when they should and told us medicines were handled safely. Risks associated with people’s care and support had been assessed and steps to reduce risks were in place to ensure people remained safe. Staffing numbers had been kept under constant review and people received their care and support from a small team of regular staff and felt the continuity of care they received was good.

People were involved in the initial assessment and the planning of their care and support; some had chosen to involve their relatives as well. Care plans contained good detail about people wishes and preferences. People told us their independence was encouraged wherever possible and this was supported by the care plan.

People told us their consent was gained at each visit through discussions with staff. People were supported to make their own decisions and choices. No one was subject to an order of the Court of Protection. Some people chose to be supported by family members when making decisions. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood the principles of the MCA.

People felt safe using the service and when staff were in their homes. The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe. Recruitment checks were carried out on new staff.

New staff underwent a thorough induction programme, which included relevant training courses and shadowing experienced staff, until they were competent to work on their own. Staff were supported and received training appropriate to their role and relevant to the needs of people they supported. Staff had gained or were working towards qualifications in health and social care.

People were supported to maintain good health. People told us how observant staff were in spotting any concerns with their health. The service worked jointly with health care professionals, such as community nurses. People had support to eat and drink well.

People felt staff were very caring. People said they were relaxed in staffs company and staff listened and acted on what they said. People were treated with dignity and respect and their privacy was respected. Staff were kind and caring in their approach and knew people and their support needs very well.

People told us they received person centred care that was individual to them. They felt staff understood their specific needs relating to their age and physical disabilities. Staff had built up relationships with people and were familiar with their personal histories and preferences.

People told us that communication with the office and registered manager was very good. People saw senior staff regularly, because they also undertook some of people’s care and support. People felt confident in complaining, but did not have any concerns. People had opportunities to provide feedback about the service provided. People felt the service was well-led and well organised.

The provider had a set of aims and objectives, which included treating people as individuals and being respectful, promoting people’s independence and supporting people to the best of their ability to live a fulfilled life and people felt they received care and support in line with these.

Further information is in the detailed findings below.