Background to this inspection
Updated
7 January 2017
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.
This inspection took place on 15 and 18 November 2016 and was announced. We gave the service 48 hours’ notice because the location provides personal care for people who live in their own homes. We needed to make sure the registered manager was available to meet us. We asked them to make arrangements for us to visit people in their own homes. The inspection was carried out by one inspector. We were also supported by an ‘expert by experience’ who contacted people and/or their relatives by telephone to seek their views on the service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before this inspection we asked the provider to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also looked at other information we had received about the service since the last inspection.
During the inspection we met with the registered manager and four members of staff. We spoke with a further three members of staff on the telephone, including the provider’s ‘head of clinical excellence’. We visited three people in their homes and spoke with two people on the telephone. We spoke with, or met, eight relatives. We also contacted health and social care professionals to seek their views on the service.
During the inspection we looked at a range of records the provider is required to maintain. These included seven service user support plans, medicine administration records, staff rotas, four staff recruitment files, staff training records, and quality monitoring records. We also looked at records of accidents, incidents, compliments and complaints and safeguarding investigations.
Updated
7 January 2017
This inspection took place on 15 and 18 November 2016 and was announced. We gave the service 48 hours’ notice because we wanted to meet the registered manager and needed to be certain they would be available during the inspection. This also gave the registered manager sufficient time to ask some people if they would be willing for us to visit and speak with them in their homes. During this inspection we found no breaches of regulations and we found people received a good service.
Newcross Healthcare Solutions (Taunton) provides personal care and support to adults and children with complex care needs living in their own homes. This included sitting services, night support and 24 hour care. At the time of this inspection they provided care and support to 16 people.
There was a registered manager in post. 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 kept safe and free from harm. A relative told us, “I don’t trust anybody with my child…but I place my trust in Newcross carers over the nurses and consultants”. People using the service, and staff, had access to a 24 hour ‘on-call’ service, which meant they could ask for guidance or additional support at any time. The provider had a robust recruitment process which minimised the risks of abuse to people. Staff had received training and information on how to recognise and report any suspicions of abuse and they were confident any concerns would be acted on promptly.
There were systems in place to ensure people received their medicines safely from staff who were trained and competent to carry out the task. Continuous observation and auditing ensured these systems were maintained and action taken to minimise the risk of errors, for example additional training for staff or support from a nurse mentor.
There were appropriate numbers of staff employed to meet people’s needs and provide a reliable and safe service. People were confident staff were never rushed and always stayed for the correct length of time. A relative told us, “They arrive on time always. They refuse to leave early; they will say we are here until eight, so we will stay till eight”. People had a consistent staff team, with whom they had been carefully matched to facilitate the development of a trusting and comfortable relationship.
People were supported by a well-trained team of staff with the knowledge and skills required to meet their individual needs. All staff, including the registered manager, received regular supervision and support. They were enabled by the provider to keep up to date with best practice through the sharing of information from recognised sources including the Nursing and Midwifery Council (NMC), Royal College of Nursing (RCN) and the Care Quality Commission (CQC) and participation in various networks and specialist forums.
Risk assessments and care plans were comprehensive and developed collaboratively with the person, their relatives and other health and social care professionals. Registered nurses were employed to support the staff to maintain safety for all care packages. Care plans were reviewed regularly which meant staff were able to continue to meet people’s needs as they changed. Effective communication systems ensured that this information was shared promptly with the person and the team supporting them, with the person’s consent.
Where required people were supported, as part of their care package, to access food and drink and maintain their nutrition and hydration according to their needs and preferences. Staff received specialist training where required, for example, ‘peg’ training (percutaneous endoscopic gastrostomy), to support people with feeding when oral intake was not adequate.
People’s legal rights were protected. People who used the service and others involved in their care were fully involved and consulted. People were always asked for their consent before staff assisted them with any tasks. Staff respected people’s privacy and people were treated with respect and dignity.