Background to this inspection
Updated
10 November 2016
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 3 October 2016 and was announced. The provider was given 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
The inspection team consisted of an inspector and an 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.
Before 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 it does well and what improvements they plan to make.
Before we visited the office on 3 October 2016 we made telephone calls to people using the service or their relatives. We spoke with seven people who used the service. We spoke to a relative the day after our inspection visit.
On the day of our site visit we looked at five people’s care plans and associated records. We looked at staff training records and schedules of their supervision meetings and appraisal. We looked at two staff recruitment files to see how the provider operated their recruitment procedures to ensure they only recruited staff that were suited to work for the service. We looked at records associated with the provider’s monitoring of the quality of the service. These included records generated by the provider’s electronic system for monitoring home care visit times. We spoke with the registered manager, two care workers and a homecare visit coordinator.
We contacted the local authority that funded some of the care of people using the service who provided us with a copy of a report of their inspection of the service.
Updated
10 November 2016
The inspection visit took place on 3 October 2016 and was announced. We gave the provider 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.
Nurse Plus and Carer Plus is a home care agency based in Newcastle under Lyme, Staffordshire. It supports people who live in their own homes in a variety of ways including providing personal care which is a regulated activity. At the time of our inspection 23 people received personal care.
The service had a registered manager. 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 who used the service were safe. They were supported and cared for by staff that had been recruited under recruitment procedures that ensured only staff that were suited to work at the service were employed. Staff understood and discharged their responsibilities for protecting people from abuse and avoidable harm. They advised people about how to keep safe in their homes.
People’s care plans included risk assessments of activities associated with their personal care routines. The risk assessments provided information for care workers that enabled them to support people safely but without restricting their independence.
Enough suitably skilled and knowledgeable staff were deployed to meet the needs of the people using the service. This meant that with very few exceptions home care visits were made at times that people expected.
People were supported to receive the medicines by staff who were trained in medicines management.
Care workers were supported through supervision and training. People who used the service told us told us they felt staff were very well trained and competent.
The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.
Staff understood the importance of people having health diets and eating and drinking. They supported people to have meals. They also supported people to access health services when they needed them.
People were involved in decisions about their care and support. They received the information they needed about the service and about how the service could support them.
People told us they were treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service.
People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. When people expressed preferences about their care and support these were acted upon by the service.
The provider had effective arrangements for monitoring the quality of the service. These arrangements included asking for people’s feedback about the service and a range of checks and audits. The quality assurance procedures were used to identify and implement improvements to people’s experience of the service.