Ison Nursing Agency and Care Services Ltd

Updated 16 February 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an Expert by Experience who made telephone calls to people and their family carers to get feedback on the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own houses. 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:

This inspection was announced. Inspection activity started on 26 January and ended on 28 January 2021. We visited the office location on 26 January 2021.

What we did before the inspection:

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection:

We spoke with the registered manager, and two other members of the management team. We also spoke with two care staff during the office visit and two additional care staff on the phone.

We reviewed recruitment records for three staff members, including their training and supervision records. We reviewed care records for five people on the electronic care system and checked the team's training log. We reviewed how accidents and incidents are managed and reviewed the quality assurance processes at the service. We also looked at two medicine administration records (MAR) and daily care logs.

After the inspection visit:

We received reviews of people’s care packages; results of the most recent survey and quality audits of medicines and spot checks of people’s care.

We spoke with three people who used the service on the phone and ten relatives.

We also received feedback from two health and social care professionals who worked with the service.

Updated 16 February 2021

About the service:

Ison Nursing Agency and Care Services Ltd is a domiciliary care agency. It provides personal care to adults living in their own homes, with a range of disabilities. At the time of the inspection it was providing care to 79 people.

People’s experience of the service

People and their relatives told us staff were extremely competent in their caring role and were kind. People had consistent care staff the majority of the time, so they fully understood people’s needs and how they liked care provided. Relatives told us they had full confidence in the care provided and the management team were responsive if any issues arose.

At the last inspection we found a breach of the regulations in relation to the management of the service. We found that whilst the management team and care staff knew people’s needs well and provided a personalised service to people, this was not always reflected in the care records and risk assessments. At this inspection we found there were significant improvements and the service was no longer in breach of the regulations. The management team had risk assessments in place, implemented regular audits and people and their relatives told us the management team were regularly in contact with them.

People were safeguarded against the risks of abuse and harm by the systems and by the staff, who received training in safeguarding adults. Safe recruitment practices took place, so staff were considered appropriate to work with vulnerable people.

Medicines were safely managed and people were supported with nutrition and hydration as needed.

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.

We saw that the service worked in partnership with other health and social care professionals. People were supported to access external health professionals to help promote good health and wellbeing. Health and social care professionals told us the service worked effectively with them and communicated well.

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

Rating at last inspection:

The last rating for the service was requires improvement (published 20 January 2020). There was a breach of regulation in relation to the management of the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.