Nurse Next Door

Updated 13 February 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

This inspection was completed by one inspector.

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 did not have a manager registered with CQC. The last registered manager left the service at the end of March 2020. Registered managers are legally responsible for how the service is run and the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because managers are often out meeting people and staff. We wanted to make sure someone would be available to meet with us

The inspection site visit took place on 12 November 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used this information to plan our inspection.

During the inspection

We visited the offices of this service. We spoke with the management team responsible for managing this service in the absence of a registered manager. This team comprised of the owner, the compliance manager and another manager. We also spoke with two staff. We inspected four care files and four staff files. We also reviewed a variety of records relating to the management of the service.

After the inspection

We spoke with twelve people who used the service and two relatives on the telephone.

Updated 13 February 2021

About the service:

Care More is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the present time it provides a service for 110 people. Not everyone using the service receives personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People's experience of using this service and what we found:

At the time of this inspection there was not a manager in place who was registered with the CQC . Also CQC had not received an application for a new registered manager that could be approved. The previous registered manager left the service at the end of March 2020. A management team was in place in the interim period.

People were protected from the risk of abuse. The service had safeguarding procedures in place that staff were well aware of. Staff received training on safeguarding people.

Comprehensive risk assessments and risk management strategies were in place as part of the assessment and support planning process. This meant risks to people and to staff were minimised.

There were robust recruitment practices in place and sufficient staff levels to meet people's needs.

The provider had reviewed their medicines policy and procedure and all staff received appropriate training. This meant people received their medicines safely and staff had clear guidance to follow, informed by models of best practice.

The provider ensured that all their staff received appropriate training and support to understand and to manage Covid 19. This included best practice for infection control and the use of PPE.

Staff also received appropriate guidance on how to support people with dementia to understand the pandemic and Covid 19. The provider made appropriate support services available to staff in order to support their mental wellbeing through the pandemic and if they became unwell and when they returned to work.

Accidents, incidents and risks were appropriately recorded and included details of preventive strategies used by the service to reduce the likelihood of events occurring in the future.

People all told us they thought the service was well led and that they were very happy with the support they received.

Staff told us the service was well led by the owner and the management team. They said they employed innovative ways of working to develop the service. There were effective systems in place to monitor the quality of the service provided to people which ensured good governance.

Technology was used effectively by the provider to ensure people were informed promptly about potentially missed or late calls.

The service had systems in place to notify the appropriate authorities where concerns were identified. The culture of the service was positive, open and person centred.

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 good (published 19 June 2018). At this inspection we rated the service as good.

Why we inspected: We carried out this inspection following a routine review of information we held about this service. Our intelligence indicated that there may be a higher level of risk at this service. As a result we undertook a focussed inspection to review the key questions of safe and well-led only. We applied the ratings limiter to well-led.

Follow up: We will continue to monitor information we receive about the service and we will re-inspect when we feel it is necessary.