Archived: Essential Nursing and Care

Updated 22 October 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.

The inspection was announced and took place on 7,8 and 13 September 2016. Further phone calls were completed on 9,12 and 15 September. The provider was given 48 hours’ notice because the location provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be at the office and able to assist us to arrange home visits.

The inspection was carried out 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 service.

Before the inspection we reviewed information that we held about the service. Providers are required to notify the Care Quality Commission about events and incidents that occur including injuries to people receiving care and safeguarding concerns. We reviewed the notifications that the service had sent to us and contacted the local quality assurance team to obtain their views about the service.

The provider had not completed a Provider Information Return (PIR) because we had not requested that they do so. A PIR is a form that asks the provider to give some key information about the service, what the provider does well and what improvements they plan to make. We gathered this information during the inspection.

We spoke with five people in their homes and four relatives. We also telephoned 20 people and relatives to obtain their views about the service. We also spoke with five members of staff. We spoke with the registered manager and the proprietor.

We looked at a range of records during the inspection. These included five care records and three staff files. We also looked at information relating to the management of the service including quality assurance audits, policies, risk assessments and staff training.

Updated 22 October 2016

Essential Nursing and Care Dorchester office is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing support to 38 people. The service was run from an office in the centre of Poundbury.

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.

When we last inspected the service in March 2014 we had concerns about the assessment and quality of service provision and respecting and involving people who use services. We asked the provider to take action about these concerns. At this inspection we found that improvements had been made in both areas.

People and their relatives told us they felt safe with the staff who provided their care and support. Staff were aware of their responsibilities in protecting people from harm and knew how to report any concerns about people's safety or wellbeing. People had individual risk assessments giving staff the guidance and information they needed to support people safely.

People were supported by staff who were familiar to them and we saw that staff had enough time with people to meet their assessed needs

Medicines were administered safely and gaps in recording were highlighted and managed by regular audits. Staff undertook medicines competency and refresher training.

People received care and support from staff who had the skills and training to meet their needs. Staff spoke highly about the training offered and as well as mandatory subjects, undertook training in specific topics including Parkinsons, Diabetes and Respiratory Awareness.

Staff sought consent from people before providing support and they were aware of the principles of the Mental Capacity Act and had received training in this area.

People were supported to have enough to eat and drink by staff who understood what support they required. We observed staff offering people choices about what they wanted and preparing food and drinks in the way people preferred.

People were supported to access healthcare services when required and staff communicated any requests for referrals to the office.

People told us that staff knew what their preferences were and how they liked to be supported. Staff were kind and caring and we observed that they had a relaxed and comfortable rapport with people we visited.

People had input into their care plans and these contained details about people’s likes and dislikes. Staff offered people choices about how their received their support and knew what was important to them.

We observed staff treating people with dignity and respect and encouraging people to be independent with the support they received.

People were not always told about changes to their care and did not consistently receive a rota telling them who would be visiting. The service had already identified this gap from feedback they had received and had put measures in place to improve this.

People and relatives were involved in regular reviews about their support and encouraged to feedback through surveys and telephone calls. Feedback was also sought from staff using regular surveys and information was used to develop and improve practice.

People, relatives and staff felt that the management of the service was good and told us that they were able to contact someone in the office when they needed to; support was also available out of hours. People were aware of who to contact if they were unhappy about any aspect of their care and support and there was a system in place to manage complaints.

Communication between staff and management was positive. Staff were encouraged to raise issues and discuss queries and felt valued in their role. There were regular staff meetings where practice and ideas were discussed and staff also received regular newsletters keeping them up to date with changes and recognising achievements.

Quality assurance systems at the service were regular and information received was used to identify trends or areas for development.