Peach Nursing Ltd

Updated 2 March 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14, 19 and 21 November 2018and was announced. We provided 48 hours' notice of the inspection because the service provides support to people in the community and we needed to ensure that the registered manager was available to provide the information we needed to carry out this inspection. The inspection was undertaken by one inspector.

The inspection of Peach Nursing Limited office took place on 14 November 2018. We visited people in their own homes on 19 November 2018 and spoke with staff employed by the service and relatives on 21 November 2018.

Before the inspection we reviewed information, we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We also reviewed the provider information return (PIR) submitted to us. This is information that the provider is required to send to us, which gives us some key information about the service and tells us what the service does well and any improvements they plan to make.

During the office visit, we spoke with the registered manager, who is also the provider of the service, two people who used the service, six relatives and seven staff members. We also received feedback from four health care professionals involved in people`s care. We looked at the care records for four people who used the service, three staff`s employment records, training, service user guide and other records relevant to the management of the service.

Updated 2 March 2019

This inspection took place on 14, 19 and 21 November 2018 and was announced. This service is a domiciliary care agency. Peach Nursing Limited is registered to provide personal care, treatment and support services to people in their own homes. It provides a service to older adults, people living with physical disabilities, people with sensory impairment and younger adults. At the time of the inspection there were 24 people using the service.

On 14 November 2018 we inspected Peach Nursing Limited office. On 19 November 2018 we visited people who used the service and on 21 November 2018 we spoke with people, staff and relatives to get feedback about the service provided.

The service had a registered manager, who is also the provider of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People with complex neurological conditions were supported to live in their own homes by the service. The registered manager ensured that people were discharged safely from hospitals in to their own homes making all the necessary arrangements for people to receive seamless care from exceptionally well-trained staff and health care professionals involved in their care.

Staff received be-spoke training about each person before they started using the service and where possible supported people in the hospital or the health service they were using prior to being discharged home. This meant that people received safe and effective care immediately and their needs were fully met by staff.

The registered manager established close working relationships with lead neurologists, consultants, physiotherapists and GP`s involved in people`s care to ensure that people`s health care needs were fully met and people were safely cared for in their own homes.

People nutritional needs were effectively managed by staff both when people needed PEG feeds or any other diets which was based on their preferences or cultural needs.

People`s health and well-being improved due to the care and support they received, some people regained their independence and confidence; others had less infections and their condition stabilised which was significant due to the complexity of their medical conditions.

Risk assessments in place assessed risk to people as well as staff in terms of environmental factors and risk to people`s health and care they received. Risks were effectively managed and this protected people from the risk of harm. The registered manager regularly reviewed people`s care and support needs together with them or family members if appropriate. The service was flexible in increasing or de-creasing the support dependent on people`s needs.

People and where appropriate their families received clear information about what the service offered, costs involvement and clear agreements were signed by both the registered manager and the person commissioning their services. Each person had a bespoke care and support package. There was a team of staff allocated to each person which meant that people had continuity of care and support.

There were enough staff employed through robust procedures to meet people`s needs. Staff understood their roles and responsibilities. They were coached and mentored by the registered manager as well as had opportunities to develop their skills and careers further. Staff received supervision and support, and had been trained to meet people’s individual needs.

People were supported by staff who was kind, caring and delivered care and support to people in a respectful and dignifying way.

People and their relatives told us they were extremely happy with how they were supported and staff become part of their family. They also told us staff were sensitive and respected their home environment and right to privacy.

People were supported by staff to continue to live the life they wanted or were able to. Where people were able to express their wishes, staff supported them to continue to live a social life, going on holidays or pursue hobbies and interest. Where people were less able staff gathered information on past interest from family members and ensured they involved people as much as possible in continuing to enjoy what they liked.

The registered manager regularly visited people in their own homes to ensure staff were following the care and support plans and they completed monitoring records appropriately. They also gathered feedback from people and their families about the service.

The registered manager was dedicated and passionate about the service they offered people. They continuously developed their knowledge in people`s complex neurological conditions by doing regular nursing shifts and volunteering work to keep their professional registration and nursing prescriber skills up to date. They positively challenged other health professionals to ensure the treatment people received was in their best interest and their health was maximised.

People and their relatives were extremely complimentary about the registered manager and their ability to provide a service which was tailored to their individual needs. They told us they felt the care and support they received was beyond what money could buy and they were more than satisfied with the service.

The registered manager effectively delegated their nursing responsibilities to staff after they ensured staff had their competencies observed by them and also up-skilled staff to effectively manage the service when they were on leave. There were effective governance systems used by the registered manager to ensure they maintained a high-quality service to people and their families.