Next Steps Community Care LTD

Updated 16 March 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 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 announced inspection was undertaken by one inspector.

The inspection took place between the 7 and 9 February 2018. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The registered manager also had to arrange for us to accompany care staff during their work and gain consent from people and relatives we wished to speak with.

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 looked at this and other information we hold about the service. This included information from notifications the provider sent to us. A notification is information about important events which the provider is required to send to us by law.

As part of our inspection planning we requested, and received, information from those organisations who commission care at the service. We asked for feedback from the local safeguarding authority and the community nursing team.

On the 7 February 2018 we visited the service's office to speak with the registered manager, the nominated individual (NI). The NI is the person who has overall responsibility for the management of the regulated activity, and ensuring the quality of the service provided. We also spoke with the service manager, a team manager, six care staff and the recruitment manager. We visited and spoke with four people in their homes and one person two people who visited the office.

On 9 February 2018 we spoke with two relatives and a community healthcare professional by telephone.

On the 7 February 2018 we observed the way people were being cared for. This was to help us understand the experience of people who could not talk with us. We looked at the care records for four people which included their medicines’ administration records and two new staff's recruitment files.

We also looked at records for the management of the service, staff training and supervision planning records, complaints and compliments, and accident and incident records. This was as well as the provider’s 2017 quality assurance survey for people, relatives and staff.

Updated 16 March 2018

Next Steps Community Care LTD is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger adults, people living with dementia, people with physical disability, people with autism or learning difficulties and people with a sensory impairment. Not everyone using Next Steps Community Care LTD received a regulated activity; Care Quality Commission (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.

The announced comprehensive inspection took place between the 7 and 9 February 2018. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The rating at our previous inspection was 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 on-going 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.

A registered manager was in post. 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.

People were kept safe by staff who knew how to recognise and report any potential harm. A sufficient number of staff were in post and any new staff continued to be recruited in a safe way. Risk to people were identified and managed. Trained and competent staff administered people’s medicines safely. Infection prevention and control systems were in place and staff cared for people as hygienically as practicable. Systems and processes were in place that enabled the provider to take on-board any learning when things did not go as planned.

Staff were trained and had the skills they needed to meet people’s assessed care and support needs. People were supported with their nutritional and health care requirements. Staff worked with external stakeholders who were also involved in people’s care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People continued to be cared for with dignity and respect by staff who showed them compassion. People’s preferences were respected by staff who knew each person well and how to meet these.

Staff promoted people’s privacy and people could be as independent as they wanted to be.

People’s care was person centred and their records reflected this. People were treated equally no matter what their needs were. Concerns were acted upon before they became a complaint. People were given accessible ways to raise concerns. Policies and procedures were in place as guidance for staff should any person require end of life care.

The registered manager led by example and they had maintained an open and honest staff culture. Staff were aware of the standard of care that was expected. People, relatives and staff had a say in how the service was run. The registered manager remained aware of their responsibilities. Staff were supported in their role. Quality assurance, audit and governance systems were effective in driving forward improvement. The service and its staff team worked in partnership with others and people’s wellbeing benefited from this.

Further information is in the detailed findings below.