Background to this inspection
Updated
10 March 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 team included two inspectors, an assistant 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 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 48 hours’ notice of the inspection. This was to establish the safest and most appropriate way of carrying out our inspection visit during the COVID-19 pandemic. Inspection activity and planning started on 13 January 2021 and ended on 25 February 2021. We visited the office location on 25 February 2021.
What we did before the inspection
We reviewed information we had about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
Due to the COVID-19 pandemic we needed to limit the time we spent at the office. This was to reduce the risk of transmitting any infection. We spoke with seven people who used the service and eight relatives and representatives of people to get their feedback about the care and support they received. We spoke with five staff to find out what it was like to work at the service.
We asked the registered manager to send some records for us to review. This included a variety of documents relating to the support people received, management of the service, audits and training. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager. We reviewed a range of records. This included multiple medication records. We looked at a variety of records relating to the management of the service, including staff recruitment, COVID-19 management and contingency planning, quality assurance systems, complaints and incident management.
Updated
10 March 2021
About the service
Nightingale Homecare East Sussex Ltd is a Domiciliary Care Agency (DCA) that provides personal care and support to 63 people living in their own homes, some of whom were older people, and/or had physical disabilities, and some people who were living with dementia.
Not everyone who used the service received personal care. 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
People’s medicines were managed safely. People were protected from avoidable harm and abuse. Safeguarding policies and procedures were embedded within practice and were consistently followed. Staff had recognised signs of abuse and had recorded their concerns.
People told us they were happy with the care they received, and that staff helped them to feel safe.
Risk assessments and care plans guided staff in how to provide care safely and in the way the person preferred. There were enough suitable staff employed to cover all the care visits. People said they received their calls on time and for the duration that they expected.
People received care that was tailored to meet their individual needs and choices, while staff were responsive to changes in their needs. Care plans guided staff about people's needs and how to meet them. People’s concerns and complaints were listened to and used to improve the service they received. When people wished to discuss their end of life wishes, these were captured and carried out by staff.
Systems for monitoring quality and managing risks had been improved. There were arrangements to support governance and to provide management oversight. People, their relatives and staff told us that communication was good and that staff listened to them and involved them in their care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 3 August 2019). There were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out a comprehensive inspection of this service on 14 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well Led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nightingale Homecare East Sussex Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.