Background to this inspection
Updated
28 February 2018
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 was the second comprehensive inspection of the service. It took place on 11, 12, 18 and 19 December 2017 and was announced. The provider was given 48 hours’ notice, because the service provides a community care service and we needed to ensure someone was available to facilitate the inspection.
One inspector and an expert by experience carried out the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
At the last inspection in November 2016, the provider was in breach of the regulations and we rated the service requires improvement.
Prior to the 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 improvements they plan to make.
We planned for the inspection using information we held about the service. This included statutory notifications. A statutory notification is information about important events; the provider is required to send us by law. We also took into consideration information we had received from commissioners who monitor the care and support of people using the service.
During the inspection, we visited two people receiving personal care from the service. We spoke with two care staff, the deputy manager and the area manager.
We reviewed the care records of two people using the service and three staff recruitment files. We also reviewed records relating to the overall management and quality monitoring of the service.
Updated
28 February 2018
NAS Community Services (Northamptonshire) is a domiciliary care agency. It provides personal care to older adults with learning disabilities living in their own homes in the community.
The first comprehensive inspection of the service took place on 30 November 2016, and we rated the service ‘Requires Improvement’. The provider was also in breach of Regulation 17 of the Health and Social Care Act Regulations 2014, Good governance. This was because sufficient quality assurance systems were not in place to assess the safety and welfare of people using the service. The provider completed an action plan telling us how they planned to improve the service to meet the breach in regulation.
This inspection took place on the 11, 12, 18 and 19 December 2017. We checked whether the provider had completed the actions as set out in their action plan. We found they had made sufficient improvement of the service and had met the breach in regulation.
At the time of our inspection, two people were receiving care under the regulated activity of ‘personal care’.
The registered manager had left the service in September 2017. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The provider was actively seeking to recruit a new registered manager. The deputy manager was providing interim management of the service supported by the area manager. Soon after the inspection, the provider confirmed they had been successful in appointing a new manager and they would be submitting an application to register with CQC.
Lessons had been learned to improve safety across the service. The provider was committed to the continual improve the service and sought feedback from people using the service to increase their involvement in developing the service. Quality audits were taking place, to monitor the health, safety and wellbeing of people using the service. Meetings took place with senior managers to discuss and address areas identified from audits and action plans were in place with timescales for completion.
Staff had received safeguarding training so they knew how to recognise the signs and symptoms of abuse and how to report any concerns of abuse. Risk management plans were in place to protect and promote people’s safety. The staffing arrangements were suitable to keep people safe. The staff recruitment practices ensured staff were suitable to work with people. The management of medicines followed best practice guidelines. Staff followed infection control procedures to reduce the risks of spreading infection or illness.
The provider understood their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016. The AIS is a framework that makes it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information they are given.
Staff received comprehensive induction training when they first commenced work at the service. On-going refresher training ensured staff were able to provide care and support for people following current practice. Staff supervision systems ensured that staff received regular one to one supervision and appraisal of their performance.
Where the provider took on the responsibility, staff supported people to eat and drink sufficient amounts to maintain a varied and balanced diet. The staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.
People were encouraged to be involved in decisions about their care and support. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care. People had their privacy, dignity and confidentiality maintained at all times. The provider followed their complaints procedure when dealing with complaints.
People had their diverse needs assessed, they had positive relationships with staff and received care in line best practice meeting people’s personal preferences. Staff consistently provided people with respectful, kind, caring and compassionate care.
The provider fostered an open and transparent culture. When required to do so, they reported notifiable events to the CQC and other relevant agencies.