Nomase Care Ltd

Updated 7 September 2022

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection Team

The inspection team comprised one inspector and one 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 and specialist housing. The service also provides care and support to people living in four ‘supported living’ settings, so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. Inspection activity started on 18 July 2022 when we requested a range of records of care and policies and procedures. We visited one of the supported living settings on 26 July 2022 and we provided formal feedback to the registered manager and nominated individual on 3 August 2022.

What we did before the inspection

We looked at information we held about the service. This included details about incidents the provider must notify us about, such as allegations of abuse and serious accidents and incidents. We also reviewed all other information sent to us from other stakeholders, for example the local authority and members of the public.

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.

During the inspection

This was partly an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information. We gathered further evidence and made observations of care and support during a visit to a supported living service. During that visit we spoke with two people who were receiving care. We also received written feedback from seven relatives of people who were living in supported living services. We also made calls to 10 people who were receiving care in their own homes and six relatives.

We spoke with seven members of staff including two care workers, one care coordinator, the deputy manager and manager of the supported living services, the registered manager and the nominated individual who is responsible for the management of the service. We also sent a questionnaire to staff for their views and opinions of the care provision and the management of the service. We received feedback responses from 24 members of staff.

We reviewed 10 people’s care and medicine records. We looked at five staff files in relation to recruitment and supervision. We also looked at policies, procedures, and records related to the management of the service an

Updated 7 September 2022

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and/or who are autistic.

About the service:

Nomase Care Ltd is a domiciliary care agency which provides personal care and support to people living in their own homes and in supported living settings.

Not everyone who used the service received 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. At the time of our inspection 84 people were receiving support with personal care either in their own homes or in supported living settings.

People’s experience of using this service

Right support

People living in supported living settings received care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. People were encouraged and supported to identify and take part in activities and pursue interests that were tailored to them. Where appropriate, staff enabled people to take positive risks. Staff communicated with people in ways that met their needs.

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.

Right Care

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs and promoted equality and diversity in their support for people. Relatives told us their family members were happy, safe and comfortable at the service. We observed positive interactions between people and staff which corresponded to feedback we received. One relative told us, “Whenever I visit [family member] is smiling and happy. I can’t thank staff enough.”

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. There was enough appropriately skilled staff to meet people's needs and keep them safe.

Right culture

People received good quality care and support because trained staff could meet their needs and wishes. People led active lives because of the ethos, values, attitudes and behaviours of the management and staff.

We have identified some issues with the provider’s system for scheduling and monitoring care visit times. We have made a recommendation about this.

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

At the last inspection, the service was rated as requires improvement (Report published 30 April 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this focused inspection to check they 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 Safe and Well-led and part of the key question Effective. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from ‘Requires Improvement’ to ‘Good’ based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nomase Care Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.