Northants Community Care Limited

Northants Community Care Ltd is a domiciliary care agency providing personal care to people with health and social care needs 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 13 people received personal care support.

People’s experience of using this service and what we found

The provider’s systems and processes did not always effectively monitor the quality of the service provided. Audits undertaken to monitor the quality of care provided were not always in place to identify issues needing improvement, such as the reliability of the service.

Systems and processes were in place to support people’s safety. People were supported by staff who had undergone a safe recruitment process. People and family members spoke of the friendliness and caring attitude of staff and management.

There were sufficient staff to meet people’s needs. People told us they felt safe and staff ensured they were safeguarded from harm. Staff followed the provider’s policy and procedure for infection prevention and control.

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.

Staff were supported through ongoing monitoring and good communication, which ensured information was shared in a timely manner to support in the delivery of personal care.

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 5 December 2014 and this is the 5th inspection.

The last rating for this service was Good, published on 4 June 2019.

Why we inspected

The inspection was prompted by concerns we received that safe care was not being provided to a person. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

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

Follow up

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

People’s experience of using this service:

People were happy with the care and support they received; they had developed positive relationships with staff.

Staff were described as nice, pleasant, friendly and caring. Nearly always on time and happy to spend time with people.

People were treated with respect, kindness, dignity and compassion. They had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with their personal preferences.

Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005). The provider was aware of how to make referrals if people lacked capacity to consent to aspects of their care and support.

People were protected from the risk of harm and received their prescribed medicines safely.

Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

Staff had access to the support, supervision and training that they required to work effectively in their roles.

People were supported to maintain good health and nutrition and were assisted to access other health professionals when needed.

Information was provided to people in an accessible format to enable them to make decisions about their care and support.

People knew how to raise a concern or make a complaint and there was an effective system in place to manage any complaints received.

The service had a positive ethos and an open culture. The registered manager and provider were approachable, understood the needs of people, and listened to people,staff and relatives.

There were effective systems in place to monitor the quality of the service and drive improvements.

The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.

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

Rating at last inspection: Requires Improvement (report published 22 May 2018)

Why we inspected: This was a scheduled inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

At this inspection we found the service now required improvement.

Northants Community Care Limited is a domiciliary care agency. It provides personal care to 40 people living in their own houses and flats in the community. It provides a service to both older adults and younger adults.

Not everyone using Northants Community Care Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service did not always assess people’s risk in sufficient detail. People had risk assessments in place, but they did not always cover the medical conditions that they had. Clear guidance was not always given to staff to understand how to recognise and respond to a person’s medical condition.

The service did not always notify the Care Quality Commission (CQC) when required. Staff from the service had been present in people’s homes when certain incidents had taken place, and had not notified CQC of these incidents as they were required to. This was a breach of the Care Quality Commission (Registration) Regulations 2009.

The service had 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.

Staff received safeguarding training so they knew how to recognise the signs and symptoms of abuse and how to report any concerns of abuse. The staffing arrangements were suitable to keep people safe. The staff recruitment practices ensured staff were suitable to work with people. Staff followed infection control procedures to reduce the risks of spreading infection or illness. Medicines were administered safely, and lessons were learnt from any mistakes that were made through staff communication in supervisions and team meetings.

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 induction training when they first started 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 and compassionate care.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the service. People, their relatives and other professionals told us that they had confidence in the manager’s ability to provide consistently high quality managerial oversight and leadership.

The inspection was carried out by two inspectors.

Northants Community Care Limited provides personal care to people who live in their own homes in order for them to maintain their independence. At the time of our inspection the provider confirmed they were providing personal care to 27 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs

People received medication at the right time. Records showed that medication had been administered safely and accurately.

Staff members had induction training when joining the service, as well as regular ongoing training.

They were well supported by the manager and had regular one to one supervisions.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

The service had a complaints procedure in place and people knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed