Background to this inspection
Updated
6 October 2020
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 team comprised of two inspectors. In order to minimise time spent on the location, an Assistant Inspector performed phone calls to staff members and an Expert by Experience performed phone calls to families of service users.
An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service
Service and service type
This service is a domiciliary care agency. It provides personal care to children and young people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service less than 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, commissioners and safeguarding teams who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 8 relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, managing director, training manager, nurses, and care workers.
We reviewed a range of records. This included four care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, staffing rotas and quality assurance records.
Updated
6 October 2020
NurtureCare Ltd is a Domiciliary Care Agency providing personal and nursing care to young children and young adults with complex health needs up to 29 years across Nottinghamshire, Leicestershire, Derbyshire and Lincolnshire. There were 24 children/young people receiving care at the time of the inspection.
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.
People’s experience of using this service and what we found.
Not all packages of care had full staffing levels, however the service tried to cover shortfalls in staffing or gave parents notice if they were required to help provide care.
Staff were knowledgeable about the risk of abuse and how to report this however there were concerns that not all incidents were always reported.
Staff were given training for the role, they shadowed other staff and had competencies signed off for each child/young person they were caring for.
Risks to safety had been assessed and measures were in place to reduce risk.
Medicines were administered and recorded safely.
Systems were in place to ensure people were protected against the spread of infection, however staff were not always following these procedures. Action had been taken by the management team to address this.
Staff were recruited safely.
There were systems in place to learn lessons if things went wrong and to improve safety within the service.
There were quality monitoring systems and processes in place to monitor and improve the service.
Feedback from staff and families was collected and used to improve the service.
Families told us the service responded quickly to complaints.
Staff received supervision, and the service had various methods of communicating with staff in order to keep staff updated and informed
Most staff told us support from management and nurses 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
The last rating for the service under the previous premises was Good published 11/2/2018.
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. This incident is subject to an investigation. As a result, this inspection did not examine the circumstances of the incident.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained Good. This is based on the findings at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nurture Care Ltd on our website at www.cqc.org.uk.
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.