Background to this inspection
Updated
5 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector on the first two days of the inspection, and by two inspectors on the third day.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service did not have a manager registered with the Care Quality Commission. The service was being managed by the registered manager of the Plymouth branch on a temporary basis. Their working week was shared between the Exeter and Plymouth branches. Registered managers and providers are legally responsible for how the service is run and for the quality and safety of the care provided. Since the inspection the overseeing manager has been appointed into a senior role specifically to directly support a cohort of branches, this role will involve taking the lead when a registered manager post is absent.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 27 June 2019 and ended on 26 July 2019. We visited the office on 27 June and 26 July 2019.
What we did before the inspection
Before the inspection we looked at the information we had received about the service since the last inspection. This included information such as notifications, complaints and concerns.
We did not receive a Provider Information Return (PIR) when this was requested. The provider told us they did submit the PIR but this was after the deadline and was not received by CQC.. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.
We used this information to plan our inspection.
During the inspection-
We spoke with the manager and two senior operational staff based in the Exeter branch. We visited two people in their own homes who received a care service and one relative on the telephone to get their experiences of the service. We reviewed a range of records. This included three people’s care plans, staff recruitment and supervision records, and records of complaints and compliments. We looked at other care records relating to the running of the service including records of accidents, complaints and concerns.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted three health and social care professionals who had professional knowledge of the service but received no replies. We spoke with three care staff on the telephone.
Updated
5 October 2019
Newcross Healthcare Solutions Limited (Exeter) is a domiciliary care service providing personal care to people living in their own homes in the Exeter and surrounding areas. 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 this inspection there were six people who received personal care from the service.
The service was re-registered with us in June 2018 and this is the first inspection.
The last rating for this service was good (published 12 December 2016). Since this rating was awarded the service had moved premises. We have used the previous rating to inform out planning and decisions about the rating at this inspection.
People’s experience of using this service and what we found
At the time of the inspection the previous registered manager and a senior staff member had left. Two new senior staff started work in the service in April and May,2019, a few weeks before this inspection. A supporting manager from another branch had overseen the management of the Exeter service whilst a permanent manager was recruited. They continued to manage their permanent management post, sharing their working week between the two services. The new management team were positive and enthusiastic about their jobs. A care staff told us, “The new management team are very good. They are brilliant”. Another care staff said, “The new managers are very helpful, very friendly”.
Just before this inspection took place we received information about concerns which had occurred during the period between the previous management team and the new team. We were assured that the provider had taken steps to address the management of the service and new systems were being introduced to improve the provider’s oversight of the agency. However, these processes and systems have not been tested or embedded. .
Most people we visited or spoke with told us they were happy with the service. One person complained about a lack of consistency in the staff team and told us, “They send staff I don’t know and who haven’t done shadow shifts”. During this inspection the acting manager told us they had met with the person and taken steps to address their concerns and improve the consistency of their service. This showed they had taken the complaint seriously and taken actions to address the concerns. Other people told us they were happy with the service. A relative told us, “The carers are excellent” and a person described the service as “Brilliant!”
People received care from staff who had been carefully recruited and trained to meet their individual needs. There were sufficient staff employed to ensure people received a safe and consistent service. Medicines were administered safely by competent staff. Care staff had received training on health and safety related topics and followed safe procedures, including infection control.
Staff provided care in a kind, respectful and understanding manner. Staff understood people’s complex needs and received training, supervision and information to ensure people received an effective service. New care planning systems were about to be introduced. At the start of this inspection we found some care plans did not provide sufficient information about people’s preferred daily routines, but this was addressed promptly and when we visited the service on the third day we found improvements had been made and care plans contained good information covering all areas of need.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk