Nightowls Home Care

Updated 3 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors. A third inspector supported the inspection making telephone calls to staff. An Expert by Experience spoke with people and their relatives over the telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 28 April 2021 and ended on 06 May 2021. We visited the office location on 06 May 2021.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager who is also the owner of the company. We also spoke with three people who used the service and seven relatives about their experience of the care provided. We spoke with seven members of staff including an area manager, a senior member of staff and care staff. We reviewed a range of records. This included four people’s care records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and the providers statement of purpose. This document sets out the aims and objectives of the service, where they operate and who they provide a service too.

Updated 3 June 2021

Nightowls Home Care is a domiciliary care service which provides personal care to older people living in their own homes within Colchester and Mersea Island. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people receive personal care, we also consider any wider social care provided. At the time of the inspection the service was supporting a total of 30 people, all of whom received support with personal care.

People’s experience of using this service and what we found.

The provider, who is also the registered manager was passionate about providing a good service to people, and often stepped in to provide support where this was needed, however this impacted on their ability to oversee the quality and safety of the service. Audits carried out by the registered manager had failed to identify shortfalls in the recruitment processes. Staff often worked alone when entering people’s homes, therefore robust recruitment checks were needed to ensure people were protected from unsuitable staff.

People confirmed they received a consistent reliable service from caring staff. Staff maintained regular visits which enabled them to develop relationships with the people they supported and their families.

Staff had a good understanding of safeguarding processes to keep people safe and how to report concerns. Staff were aware of people’s needs and supported them to manage risks to their safety whilst supporting them to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests.

People told us they received their medicines when they needed them. We were assured the service met good infection prevention and control guidelines.

People’s needs had been assessed before using the service. Care plans contained comprehensive information about people’s routines and guidance on how to meet their specific needs. However, further work was needed to ensure people’s views about end of life care, including their individual religious and cultural values and beliefs, were known, respected and acted on.

We have made a recommendation about end of life care arrangements

The service had received several compliments thanking staff for the care and support provided to people at the end of their life.

Staff confirmed they had received training that gave them the knowledge and skills to carry out their roles. ‘Spot checks’ were carried out by senior staff to monitor staff practice and ensure they were working safely. People told us where they needed support with their meals this was being managed well. People were supported to access healthcare where needed. Staff worked well with other professionals to ensure people’s healthcare needs were met

Staff treated people with dignity, respect and kindness. Staff understood their responsibilities to respect people’s right to privacy, confidentiality and to promote their independence. Staff had a good understanding of people's protected characteristics and were respectful of these.

Staff told us Nightowls Home Care was a good company to work for and there was a positive culture in the service. Staff intuitively were providing care in line with the values of the company but were not clear what the service’s vision, values and goals were.

Staff understood and were aware of their responsibilities to raise concerns and report incidents and near misses. Systems were in place to respond to and investigate complaints. Where things had gone wrong, the registered manager was open and transparent with people, and their relatives and used their feedback to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 4 July 2019) where we identified a breach of regulation and made recommendations for the service to improve. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been sustained and the provider was still in breach of the regulation.

The previous inspection in May 2019 found people's medicines were not always managed safely, individual risks had not always been identified or recorded to provide guidance to staff, staff had not received moving and handling training and arrangements to monitor the quality of the service needed to improve. At this inspection we found improvements had been made to ensure people received their medicines safely, individual risks had been assessed and staff had been trained to assist people to safely transfer. However, the systems to assess and monitor the quality and safety of the service had failed to identify shortfalls in the recruitment processes, which placed people at risk of harm. Unsafe recruitment practices had previously been identified at our inspection in April 2018. The inspection in May 2019 found improvements had been made, however at this inspection we found this improvement had not been sustained which means this service has been rated requires improvement for the last three consecutive inspections.

You can see what action we have asked the provider to take at the end of this full report.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.