Day and Nightcare Assistance

Updated 30 March 2018

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 was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. This inspection took place on 27 February 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service to people in their homes; we needed to be sure that someone would be in the office.

Before the inspection we reviewed the information we held about the service and the service provider. The registered provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We reviewed the previous inspection report.

We spoke with 12 people and three relatives. We looked at four people’s care records and medicine administration records (MAR). We spoke with the registered manager, the assistant manager, care coordinators and support staff. We reviewed a range of records relating to the management of the service. These included five staff files, quality assurance audits, minutes of meetings with staff, incident reports, complaints and compliments. In addition, we reviewed feedback from people who had used the service and their relatives.

Updated 30 March 2018

We undertook an announced inspection of Day and Nightcare Assistance on 27 February 2018.

This service is a domiciliary care agency. It provides personal care which includes live-in services to people living in their own homes. It also facilitates 24 hour discharge to assess for people from local hospitals back to their own homes around Oxfordshire. It provides a service to older people and younger adults. At the time of our inspection, the service was supporting 80 people.

There was 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 our last inspection we rated the service Good. At this inspection we found the evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. However, the well-led section required improvement. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Day and Nightcare Assistance was led by a registered manager who promoted a service that put people at the centre of all the service did. However, we found the staff did not feel supported and they told us there was a lack of good working relationship between staff and the management team. Staff told us they felt not listened to by the provider and registered manager. Staff felt there was a bullying and blame culture within the service.

People remained safe receiving care from Day and Nightcare Assistance. Staff had a clear understanding on how to safeguard people and protect their health and well-being. Risk assessments were carried out and promoted positive risk taking which enabled people to live their lives as they chose. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable for their roles. There were sufficient staff to meet people's needs and staff had time to spend with people. There were systems in place to manage safe administration of medicines.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People had their needs assessed prior to receiving care from the service to ensure staff were able to meet people’s needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. People were involved in decisions about their care needs and the support they required to meet those needs. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People were supported to have access to activities of their choice in the community.

People knew how to complain and complaints were dealt with in line with the provider's complaints policy. People's input was valued and they were encouraged to feedback on the quality of the service and make suggestions for improvements. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible.

The provider’s vision for the service was promoting independence and allowing people to live a normal life. This was shared throughout the staff team and embedded within staff practices. We evidenced these practices through people’s care plans and staff feedback.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care to people and promote a culture that was person-centred and achieved good outcomes for people.