Background to this inspection
Updated
24 December 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. 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
This inspection was carried out by two inspectors and two Experts 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.
Registered Manager
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 and compliance with regulations.
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 we needed to phone people using the service as part of the inspection, and we needed to get their consent to call them.
Inspection activity started on 10 August 2022 when we visited the office and ended on 28 November 2022 when we gave feedback about the inspection findings. Telephone calls were made offsite to people who used the service, relatives and staff.
What we did before the inspection
We reviewed our systems and information we held about the service. We sought feedback from the local authority. 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 of this information to plan our inspection.
During the inspection
We spoke with 21 people who used the service and 11 relatives about their experience of the service.
We also spoke with the registered manager and 10 staff who consisted of support workers, reablement practitioners and senior reablement liaison officers.
We reviewed the care plans and associated risk assessments for 15 people who used the service and a range of medicines and topical administration records for 25 people. We also looked at a range of records relating to the day to day running of the service such as quality assurance records, training data and some of the provider’s policies and procedures. The personnel files for three staff were reviewed as part of this inspection.
Updated
24 December 2022
About the service
Norfolk First Support- Northern is a domiciliary care service providing personal care to people in their own homes. 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.
At the time of the inspection there were 139 people who used the service who received personal care. Norfolk First Support-Northern provides a reablement service to people who may have been discharged from hospital, or who are recovering from illness or injury. People typically receive support for up to six weeks, and sometimes longer to help them with becoming more independent.
People’s experience of using this service and what we found
The systems to monitor and assess the quality and safety of the service currently in place were not fully effective at identifying shortfalls and driving improvement. We have made a recommendation the provider makes improvements in relation to this.
Risks in relation to people’s individual needs had not always been assessed, and risk assessments which were in place were not always sufficiently detailed. Staff understood their responsibilities in relation to keeping people safe; and knew how to report any concerns.
Assessments of people’s needs were undertaken once they had started using the service, this had led to some complications where care packages had to be revised, or additional support being requested from healthcare professionals. Staff took appropriate action in relation to these incidents.
Staff supported people to take their medicines in a safe way, but records relating to medicines could be more detailed. Staff adhered to the current guidelines in relation to infection prevention and were part of a testing programme which was in place at the time of the inspection.
Not all staff had completed their required training, however, people felt staff were well trained and staff were able to demonstrate through our conversations they understood people’s individual needs.
People’s consent was sought by staff when delivering care. 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 management and staff worked in partnership with people, their relatives and healthcare professionals to achieve good outcomes for people. People’s care was reviewed regularly, and care plans updated where people’s care needs changed.
People were supported by staff who upheld their dignity and promoted their independence.
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
This service was registered with us on 19 September 2019 and this is the first inspection.
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.