9 June 2023
During a routine inspection
N-Able Care is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection they were providing a personal care service to 1 person. This was provided by the provider and 3 self-employed carers, with the provider overseeing the care being delivered.
People’s experience of using this service and what we found
Right Support
The person had risk assessments and a care plan in place, however, these did not include sufficient information to guide staff to provide care and support. Although a small team of staff supported the person who knew the person well, they did not always have detailed guidance to ensure people received safe care at all times. We did not find this had a negative impact on the care the person received as the person receiving support was able to say what support they required, but we have identified these as areas of practice that need to improve.
Staff understood how to protect people from poor care and abuse. Some staff had not received training in safeguarding vulnerable adults.
The person was supported to have maximum choice and control of their life 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. The person told us staff supported them to be independent and to have control over their own life.
The person was supported to maintain their health and wellbeing. Staff enabled the person to access specialist health care support within the community.
Right Care
Recruitment procedures were not always safe, and improvements were needed to ensure staff received training and appropriate assessments of their competence to fulfil their role. The person told us they were involved in recruitment of their own staff.
Infection control procedures were not always robust, and staff mostly followed systems and processes to safely administer medicines. However, improvements were needed to ensure medicines records were accurate, and staff received appropriate training and competency assessments.
The person was well treated and supported. Staff knew the person and their needs and preferences well and the person received consistent care. Staff respected and promoted the person to be as independent as possible. The person confirmed to us they felt involved in their care and were aware of how to raise any concerns they may have.
The person could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The person told us their communication needs were met with written information provided to them in a format that supported their understanding.
Right Culture
Improvements were needed to make sure there were effective systems to monitor the quality of the service and plan improvements. The provider was open and transparent throughout our inspection. They acted on queries and our feedback throughout the inspection.
The person was complimentary about the care and support they received and spoke positively about the service. We found no evidence that the person was harmed by the shortfalls we found, but these shortfalls put them at increased risk. We discussed these concerns with the provider who was responsive to feedback and started making changes during the inspection to improve support for the person.
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 19 May 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to staff recruitment, staff training and management of the service at this inspection.
We have also made recommendations in relation to medicines management and infection control.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.