About the service B Pro Nursing Agency is a domiciliary care service which provides personal care to older people living in their own homes. At the time of the inspection the service was supporting 19 people.
People’s experience of using this service and what we found
The previous inspection in November/December 2019 found people's medicines were not always managed safely, there was no system for monitoring missed and late calls, personal protective equipment (PPE) was not always available and staff were not sufficiently trained for the role, especially in relation to end of life care. Staff reported a negative culture in the service and there was a lack of governance and oversight.
At this inspection we found improvements had been made to ensure people received their medicines safely, staff were trained to deliver high quality care, the culture of the service was positive and management systems were in place to monitor the quality of the service
People and their family members told us they received care and support which was reliable and consistent from caring staff. Rotas were organised in a way which meant people saw the same team of staff so that relationships were developed and maintained.
Staff had a good understanding of safeguarding processes to keep people safe and how to report any concerns. Staff understood and were aware of their responsibilities to raise concerns and report all incidents. People told us they received their medicines when they needed them. We were assured the service met good infection prevention and control guidelines and PPE was readily available. There were enough staff to provide care and support to people and staff had been suitably recruited to their role.
Staff were aware of people’s needs and supported them to manage risks to their safety whilst supporting them to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
People’s needs had been assessed before using the service. Care plans contained comprehensive information about people’s needs and ways in which they should be met. This included their routines, preferences and wishes. People had received end of life care from staff who were trained, sensitive and compassionate.
Staff confirmed they had received training that gave them the knowledge and skills to carry out their roles. Spot checks were carried out to monitor staff practice and ensure they were working safely. People had good support with their meals. People were supported to access healthcare where needed. Staff worked well with other professionals to ensure people’s healthcare needs were met
Staff treated people with dignity, respect and kindness. Staff had a good understanding of people's individual lifestyles and culture and respected people’s right to privacy, confidentiality and promoted their independence. Staff recorded information about people in a respectful way.
Systems had improved to assess, manage and monitor the oversight and quality of the service. Complaints were investigated and responded to. Where things had gone wrong, the registered manager and care coordinator was open and transparent with people, and their relatives and used their feedback to improve the service.
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: The last rating for this service was requires improvement (published 16 March 2019) and where we identified breaches of the regulations and made recommendations for the service to improve. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvement had been made and the provider was no longer in breach of the regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.