Nexxus Care- Cannock

Updated 27 July 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and 1 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 72 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 15 May 2023 and ended on 22 May 2023. We visited the location’s office on 15, 16 and 22 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the office visit, we spoke with the registered manager, a care co-ordinator, the operations director, and the chief operating officer who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 7 care staff.

We looked at 14 people’s care records and reviewed 8 people’s medicines administration records (MARs). We also viewed 3 staff files and documentation related to the governance of the service.

The Expert by Experience spoke with 23 people supported by the provider and 18 relatives by telephone.

The provider sent us further documentation we had requested following the site visit including information regarding training and medicines.

Updated 27 July 2023

Nexxus Care - Cannock is a domiciliary care agency providing personal care to people living in their own homes and flats. At the time of our inspection there were 106 people using the service.

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

Medicines were not always administered safely. Where medicines were not administered within a required time period, set parameters on the provider’s electronic system meant they could not be recorded accurately on the medicines administration record (MAR). One medicine had also been administered without leaving sufficient time between doses. Risk assessments were not always in place to guide staff how to manage clinical risks to people safely.

Audit checks in place were not always effective to check the quality of the service. Medicines audits did not identify where medicine administration had not been recorded accurately or within the correct time period. Statutory notifications had not always been submitted when needed despite the registered manager being knowledgeable about when they were required.

Where risk assessments were in place, they were thorough and clearly guided staff how to meet people’s needs safely. Staff knew how to manage risk to people. A safeguarding policy was in place that was followed by staff, and they understood the types of abuse. People were supported by a sufficient number of safely recruited staff to meet their needs. People were supported by staff who wore appropriate PPE (Personal Protective Equipment) to meet their needs safely. Where things went wrong, action was taken to reduce the risk of reoccurrence.

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’s needs were assessed in a holistic manner that identified their likes, dislikes and life history. People were supported by staff who had completed appropriate training to meet people’s needs effectively. Staff were required to complete a full induction before supporting people and the provider undertook competency checks when needed. People were supported to eat and drink in line with their dietary needs. People were supported by staff who monitored their health and escalated health concerns to relevant health professionals including physiotherapists and speech and language therapists.

People were supported by staff who treated them with kindness and respect. People were supported to express their own views regarding their care. Staff supported people in a way that promoted their independence. People were supported by staff who treated them with privacy and dignity.

People were involved in implementing and revising their care plans. Staff were able to access information in people’s care plans on their visit logs which gave clear and personalised guidance on how to meet people’s needs. Communication care plans were in place that guided staff how to communicate with people to maximise their ability to understand. A complaints policy was in place and most people were confident their complaints would be addressed. End of life care plans were in place when people were at this stage of their life.

The provider promoted and disseminated to staff a person-centred ethos that focused on meeting people’s needs. The registered manager understood the duty of candour and was open and honest when things went wrong. People, relatives, and staff were involved in the running of the service and questionnaires were sent out to enable them to input. The provider worked closely with other agencies and care commissioners to provide effective support to people.

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

Rating at last inspection

This service was registered with us on 12 April 2019 and this is the first inspection. The last rating for the service under the previous provider was good, published on 25 June 2016.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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