We inspected the service on 15 October 2018. The inspection was announced and was the provider’s first inspection since it was registered.Nottinghamshire is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Nottinghamshire receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. Nottinghamshire provides a service to older adults and younger adults with a disability. At the time of our inspection, 15 people were receiving personal care as part of their care package.
A registered manager was in place and available on the day of our inspection. 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 were protected as far as possible from abuse and avoidable harm. Staff had received safeguarding training, the provider had a policies and procedures and staff were clear about their role and responsibilities. Risks associated with people’s needs including the environment had been assessed and planned for. Staff had guidance that was up to date in how to provide safe care. The provider had a system to record and analyse accidents and incidents to reduce further reoccurrence.
People were cared for by sufficient numbers of staff that had the required skills and competency to meet their needs. People received care from regular staff that knew them well. No person had experienced missed calls and late calls were infrequent, people were informed if staff were delayed. Safe staff recruitment checks were completed before staff commenced their employment.
Where required, people received safe support with their prescribed medicines. Staff had received training and had a medicines policy and procedure to support them. Staff had information about how to administer people’s medicines.
People were protected from the risk of cross contamination. Staff wore personal protective equipment, had received training in infection control and were knowledgeable about how to reduce risks to people.
People had their individual needs assessed, including their protected characteristics under the Equality Act to ensure staff understood what care was required. People were supported by staff who had received an induction and ongoing training. The management team assessed staff’s competency to provide effective care and support. Staff were knowledgeable about people’s care needs that showed they had developed positive relationships with people.
Where people required assistance with dietary and nutritional needs, staff had guidance of what was required of them. People’s healthcare needs had been assessed and staff monitored their health and acted if a person was unwell. Staff had been provided with health information factsheets to support their awareness and understanding of people’s health conditions.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported by staff that were kind, caring and compassionate and who knew them well. People received a staff rota informing them what staff to expect. Consideration of people’s language, sensory and communication needs were assessed and planned for. People were involved in their care and support.
Staff were confident they had sufficient information to provide a personalised service, important information about people’s preferences were known and understood, and care was delivered in line with this. The complaints procedure had been made available to people.
The provider had systems and processes in place to monitor quality and safety and people received opportunities to feedback about their experience if the service they received.