NR Care Head Office

Updated 12 May 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector, an assistant 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.

Service and service type

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

There was a registered manager in post. 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.

Notice of inspection

This inspection was announced.

We gave the service three working days’ notice of the inspection visit. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection visit. Inspection activity started on 21 April 2021 and ended on 23 April 2021. We visited the office location on 23 April 2021.

What we did before the inspection

The provider was not asked to complete a provider information return (PIR) prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and four relatives on the telephone about their experience of the care provided. We spoke with seven members of staff including five care workers, the registered manager and the supporting manager.

We reviewed a range of records. This included four people’s care records and associated medication records (MARs). We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies, quality assurance and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed the action plans completed after the last inspection.

Updated 12 May 2021

About the service

NR Care Head Office is a domiciliary care service. They provide personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection the service was providing a regulated activity to 20 people.

People’s experience of using this service and what we found

People felt safe when staff supported them. Staff knew how to report concerns and keep people safe from harm.

Although staff supported people safely with their medicines, records were not always thorough. There was not always full guidance in place on how and when topical creams should be administered. Allergies were not always written on the Medicines Administration Records (MARs), which meant that unfamiliar staff may not always have this information immediately available when administering medicines. However, these risks were mitigated due to the person having a regular member of staff who knew them well, administering medicines.

Risks to people were planned for and there was guidance in place for staff to manage these.

Staff were recruited safely and there were enough staff to cover people’s care visits.

Staff received training in areas relevant to their role, and where needed, related to specific people’s needs.

Staff used Personal Protective Equipment (PPE) as required by current guidelines and followed good infection control practices to reduce the risk of the spread of infection, including COVID-19.

People’s needs had been assessed thoroughly before the service agreed to deliver care so they could ensure they could meet these needs. Care plans were person-centred, with guidance for staff on how to meet their needs, including physical and mental health, family lives and interests.

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.

Staff asked for consent before delivering care, and understood people’s needs around making decisions, but further work was required around care planning records relating to people’s mental capacity. We have made a recommendation in this area.

People were, in the main, supported by a consistent group of staff who knew them well. Staff supported people in a caring way and involved them in decisions relating to their care.

Staff were supported by the service, and felt involved. Quality assurance systems were in place which identified areas for improvement, which were then acted upon. The provider recognised areas where further work was still required and had made plans for ongoing improvements.

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

Rating at last inspection and update:

The last rating for this service was Requires Improvement (published January 2020) and there were two breaches of regulation. 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 was a planned inspection based on the previous rating.

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.