Background to this inspection
Updated
12 July 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 was planned to check 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.
The inspection took place on 19 and 20 April 2018 and was announced. We gave notice of our inspection to ensure key people would be available at the service when we visited. The inspection team consisted of one inspector.
Prior to our visit we asked for a Provider Information Return (PIR). The PIR is information given to us by the provider. The PIR also provides us with key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service. This included notifications we had received from the service. Services use notifications to tell us about important events relating to the regulated activities they provide
We looked at the care records of seven people, the recruitment and personnel records of seven staff, staff schedules, training records and other records relating to the management of the service. We looked at a range of policies and procedures including, safeguarding, whistleblowing, mental capacity and complaints.
The registered manager asked people if they were willing to speak to us prior to our visit. During the inspection we spoke with six people about the service they received and one relative. We spoke with six care staff, one care coordinator, the deputy manager and the registered manager.
Six health and social care professionals were contacted in order to gain their views about the service. Two of them provided feedback about the service and this has been included in the main body of the report.
Updated
12 July 2018
This inspection took place on 19 and 20 April 2018. At our last inspection we rated the service good. At this inspection we found evidence the service was now outstanding and because of this the report is in a shorter format.
Agincare UK - Nutfield Extra Care Scheme provides personal care to people living in their own flats across four schemes. It also provided personal care services to those people who were in prison. At the time of our inspection there were 74 people using the service.
The service was managed by a registered manager. 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 told us they felt safe when using this service. Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns. Risks to people's wellbeing were assessed and action taken to reduce these. The service focused on keeping people safe whilst promoting their independence.
There were enough staff to meet people's needs and staffing levels were flexible according to people's changing needs. The registered manager followed safe recruitment practices to ensure that staff were suitable to work with people. Staff were qualified and received training that helped them to deliver a high quality service to people. The registered manager provided support and guidance to staff to ensure they were equipped to carry out their roles. Staff felt valued by the registered manager and supported in their roles.
People’s medicines were handled safely.
Where necessary people's nutritional needs were well met. Where required they supported people to access a range of health and social care professionals in the community for advice, treatment and support. Staff monitored people's health and wellbeing and responded quickly to any concerns.
Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. Staff had a good understanding of people's needs and supported them effectively.
People's achievements were celebrated and their views were sought and acted on. People were supported by staff who were compassionate and treated them with dignity and respect. Without exception, people who used the service spoke highly in their praise about the staff who supported them.
People had assessments of their needs and care was planned and delivered in a person-centred way. The service had creative ways of ensuring people led fulfilling lives and they were supported to make choices and have control of their lives.
People described how their care was delivered and what they told us demonstrated the service was extremely person-centred. Staff echoed that the service was person-centred in their feedback and our own observations and evidence gathered supported this. Every element of the approach of the registered manager and staff was centred around the person who used the service, their abilities, feelings, wishes and goals.
People who used the service accessed a range of community facilities and were involved with activities which were organised by the service.
People's end of life wishes were followed with pride and staff took great comfort when they had supported people to have the end of life they had wished for.
The service had a positive, vibrant and caring culture which people, relatives and staff supported and promoted. People told us they were well supported and well cared for. Staff were exceptional in supporting people to be as independent as possible in their lives. We saw lots of examples where people were striving towards independence.
Staff were highly motivated and reflected pride in their work. They talked about people in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care possible for each person.
The registered manager provided exceptionally strong, clear leadership and ensured an enabling and person centred culture was firmly embedded in the service. People, relatives, professionals and staff spoke very highly of the leadership, and held the registered manager in high regard. There was a clear commitment to put people at the heart of the service, by empowering and working in partnership with health and social care professionals.