Background to this inspection
Updated
14 April 2021
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 two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to 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 24 hours’ 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. We also needed to gain consent to contact people using the service by telephone.
Inspection activity started on 11 March 2021 and ended on 15 March 2021. We visited the office on 11 March 2021 and made phone calls to people who used the service, relatives and staff on 11, 12 and 15 March 2021.
What we did before the inspection
We reviewed information we had received about the service since it registered. We sought feedback from the local authority. 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 four people who used the service and two relatives about their experience of the care provided. We spoke with five members of staff including the nominated individual, the registered manager and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
14 April 2021
About the service
Nested Support is a domiciliary care agency providing personal care to people living in their own homes. The service supported eight people at the time of the inspection, all being supported with 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.
People’s experience of using this service and what we found
People were cared for in a safe manner. The service had a safeguarding policy and procedure in place. Staff attended safeguarding training and were confident in identifying and reporting abuse. Risks to people’s health and wellbeing were suitably managed. Staff were recruited safely. There was good infection control practice in the service including up to date COVID-19 guidance.
Staff acknowledged and respected people’s needs and choices. All care plans we reviewed were person centred. Peoples food and drink preferences were recorded clearly in their care plans. The staff team were supported with regular supervision, spot checks and meetings. Technology was used to ensure open communication with health care teams.
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.
People were supported by staff who were caring and kind. Feedback from people and relatives was consistently positive. Creative and innovative use of technology ensured open and transparent communication between people, their relatives, carers and relevant professionals. Staff support respected people’s privacy and dignity.
Care and support plans were reviewed and updated as people’s needs changed. People were treated as individuals and their choices were respected. People, relatives and staff felt they would feel confident to speak with the registered manager if they had any concerns.
People, relatives and staff felt that the service was consistently well-led. The registered manager had created a culture of quality person-centred care. There were clear and effective governance and accountability arrangements. We found proactive engagement with people, relatives, staff, health care professionals and community groups.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 08/08/2019 and this is the first inspection.
Why we inspected
This inspection was required because the service has been registered and carrying out regulated activities since August 2019, not yet inspected due to COVID-19 pandemic restrictions.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care service inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.