Archived: Newday Healthcare Professionals Ltd

People’s experience of using this service: People were very complimentary of the staff and the service they received.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for and supported by staff who had received the appropriate training. Staff were employed following the appropriate recruitment checks. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. There were safe medication procedures for staff to follow.

Staff had a good understanding of people’s preferences of care, staff promoted people’s independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported to eat and drink enough to ensure they maintained a balanced diet. People and their relatives were involved in the planning and review of their care. The registered manager had policies in place to respond to complaints. Support could be provided to people at the end of their life.

The provider had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection: The last rating for this service was Good. (last report published 24 June 2017).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Our last inspection of this service in October 2016 highlighted a number of concerns and we imposed conditions on the service that they could not take on new care support packages without prior application to the Care Quality Commission. The service was previously rated Inadequate overall and placed in special measures. The provider wrote to us to inform us of the actions they had taken since to improve the service. Significant improvements had been made since our last inspection, such as improved recruitment process and managerial oversight over the running of the service.

The service is required to have a registered manager. 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.

Staff delivered support effectively and care was provided in a way that promoted people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people’s individual needs to be met adequately. Trained staff dispensed medications and monitored people’s health satisfactorily.

Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. Person centred social activities took place within the service.

Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits carried out by the manager, which identified any improvements needed and actions were taken. A complaints procedure was in place and had been implemented appropriately by the manager.

This inspection took place on the 10,13, 14 October 2016 and 01 November 2016 which was announced, the inspection team consisted of two inspectors the first day and one inspector on three days that followed.

The service was last inspected in June 2016 where the Commission highlighted a number of concerns. The service was previously rated inadequate overall and was placed in special measures. Although some improvements had been made since our last inspection, the overall rating remains “Inadequate” and the service in special measures for a further 6 months during which time we will return to check if further improvements been made and sustained.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service had a registered manager in place. 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.

At this inspection we found the service had not made improvements in regards to staff recruitment and we were seriously concerned about the lack of essential checks not being carried out before staff commenced employment. We urgently imposed a condition on the provider’s registration in regards to safe recruitment practices. The service was also unable to evidence whether or not there were sufficient numbers of staff to meet people’s needs. The provider who is also the registered manager (hereafter referred to as ‘the provider’) had been struggling to manage the service as they had also been working with staff to cover care calls to people due to the lack of sufficient staff. During this inspection we found the service had not implemented nor used quality assurance systems to drive improvement of the issues highlighted at the last inspection.

The service had made improvements to ensure staff delivered support that was effective and caring and this was in a way which promoted people's independence and wellbeing, whilst people's safety was ensured.

Systems had been developed to gain people's views and the provider shared with us what this would look like once implemented. Staff were better supported as team meetings were now taking place, training was being delivered and the provider had commenced supervisions with staff including observations of their practice. A complaints procedure was in the process of being developed and we saw evidence of how this would work once implemented.

Staff understood their responsibilities and how to keep people safe. People's rights in relation making decisions were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA). The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.

People and their relatives told us staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks.

The provider now needed to ensure that areas of shortfalls were promptly addressed and where improvements had commenced that these were imbedded in long term consistent good practice.

Newday Healthcare Professionals Limited provides care services to people within their own homes. Care services include personal care, a sitting service and domestic services. The service provided are either through private arrangement or social services funding. The service covers Southend on Sea and Essex at the time of our inspection the service was providing support to 25 people all in the Southend on sea area. The service was first registered with the Care Quality Commission on the 6 June 2014.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The service had a registered manager in place. 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.

Views about staffing levels were mixed and some people felt that there was not enough trained and experienced staff available to meet their needs. We also found that people or their relatives were not fully involved in planning and making decisions about their care. The service was not responsive in identifying and meeting people's individual care needs.

The manager could not demonstrate how the service was being run in the best interests of people using the service. Arrangements in place to keep the provider up to date with what was happening in the service were not effective. As a result there was a lack of positive leadership and managerial oversight. Systems in place to identify and monitor the safety and quality of the service were ineffective as they either did not recognise the shortfalls or when they did there was a lack of action to rectify them.

Staff did not have the skills and experience, and they were not deployed effectively to meet the needs of people. We found that staff did not always have enough time to spend with people to provide reassurance, interest and stimulation. There was a lack of knowledge around supporting and caring for people living with dementia including understanding how it affected people differently and how each individual should be cared for to promote their wellbeing as far as possible.

Although relatives told us that staff treated people with kindness, we found that the way the service was provided was not consistently caring. Staff did not always demonstrate a caring attitude towards the people they supported and some failed to promote people's dignity or show respect to individuals. The majority of interactions by staff were routine and task orientated.

Whilst staff were able to recognise poor practice, suitable arrangements were not in place to respond appropriately where an allegation of abuse had been made.

You can see what action we told the provider to take at the back of the full version of the report.