Niche Care Sheffield

Niche Sheffield is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting approximately 240 people. 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

We received mixed views from people and relatives about the quality of care. Some were satisfied with the quality of care and made positive comments about the staff. Comments included, “I have nothing, but praise for the carers” and “Yes, they [staff] are looking after me okay. They are all very pleasant.” Some told us the lack of regular care workers and inconsistent calls times impacted on the quality of their care. Comments included, “There is no consistency of care” and “A few weeks ago, two carers came in who just didn’t know what to do.”

We checked to see if enough improvement had been made so people experienced continuity of care and experienced consistent call times. At this inspection we found further improvement was required.

Systems in place to ensure people were protected from abuse and improper treatment required improvement. Care staff were aware of their responsibility to report concerns or changes in people’s needs. However, some staff were not confident these were recorded or/and actioned by office staff. Care staff told us the registered manager responded to concerns promptly and took appropriate action.

The provider had not ensured each person using the service has an accurate, complete and contemporaneous care plan in place. We found the management of medicines required improvement. Most people and relatives told us staff used gloves, masks and aprons appropriately whilst supporting them or their family member.

The providers recruitment processes required improvement. Some staff felt supported, whilst others felt unsupported and not valued. The registered manager told us it had been challenging to deliver regular supervisions during the pandemic. Staff, people and relatives shared concerns about the training of new inexperienced staff. The registered manager told us all staff would complete the new content training by the end of May 2021.

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.

The provider had systems in place to engage and involve people using the service and their representatives. However, relatives and people shared concerns about the poor response to their calls to the office. Staff did not always ring back as promised. There were missed opportunities to continue to learn and improve service delivery.

The systems in place to assess, monitor and mitigate the risks relating to the health and safety of people were not effective in practice.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this was requires improvement 18 February 2020.

Why we inspected

The focussed inspection was prompted in part due to concerns received about the safety, quality of care and management of the service. The information CQC received indicated concerns about the safe care and treatment of people. This inspection examined those risks. We undertook a focussed inspection to review the key questions, safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The last rating for this service was requires improvement (published 18 February 2020). The service remains rated requires improvement. The service has been rated requires improvement for the last two consecutive inspections.

We found evidence the provider needs to make improvement. Please see the safe, effective and well-led sections of the full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We identified breaches in relation to the management of people's risks, records and quality assurance.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Niche Care Sheffield is a domiciliary care service which provides personal care to adults with a range of support needs in their own homes. At the time of this inspection the service was supporting 180 people.

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

Not everyone we spoke with was able to confirm they received the same group of regular care workers or that they arrived on time. Some people told us they were unable to get through to office staff on the telephone to discuss their concerns. The registered manager told us there had been problems with the recruitment and retention of office staff which had impacted on staff rotas and answering telephone calls. However, they felt things had recently settled down and they were confident people would start seeing improvements in this area. The provider audits we looked at confirmed improvements were being made.

We have made a recommendation to the registered manager about keeping a summary of each complaint and safeguarding issue so any common themes or trends can be easily identified.

The provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background. Staff understood what it meant to protect people from abuse. Where people needed support with managing their medicines there were systems in place to ensure people received their medicines as prescribed.

Staff were provided with relevant training and ongoing support to make sure they had the right skills and knowledge to support people. Staff told us the registered manager was approachable and they felt supported in their jobs.

People were supported to eat and drink to maintain a balanced diet, where required. People were supported to maintain good health and have access to health and social care services as required

Staff understood the requirements of the Mental Capacity Act 2005. 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.

People told us staff were kind and caring. Staff knew how to treat people with dignity and respect.

There were systems in place to respond to complaints. People told us they knew how to complain. The provider had policies and procedures which reflected current legislation and good practice guidance. There were effective systems in place to monitor and improve the quality of the service provided.

Rating at last inspection

This service was registered with us on 20 December 2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

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.