Archived: NurseplusUK

Updated 31 December 2016

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 registered persons were 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.

Before our inspection visit we reviewed information we held about the service. This included the Provider Information Return (PIR). This is a form the registered persons had completed to give some key information about the service, what the service does well and improvements they planned to make. We also reviewed other information we held about the service such as notifications. These refer to events that happened in the service which the registered persons are required to tell us about.

We also spoke by telephone with 10 people who used the service and with two of their relatives. We did this to obtain their views about how well the service was meeting people’s needs. In addition, we spoke by telephone with five members of staff (care workers) who provided care for people.

We visited the administrative offices of the service on 23 November 2016 and the inspection team consisted of a single inspector. The inspection was announced. The registered persons were given a short period of notice because they are sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available to contribute to the inspection.

During the inspection visit we spoke with the business support manager, registered manager, care relief branch manager, a care coordinator and the client assessor. In addition, we examined records relating to how the service was run including visit times, staffing, medicines management, training and quality assurance.

After the inspection visit we spoke with the head of quality assurance. This was because we needed further information about parts of the quality management system used in the service.

Updated 31 December 2016

Nurse Plus and Carer Plus (UK) Limited is registered to provide nursing and personal care for people in their own homes. It also provides a service to people who run care homes by supplying nurses and care staff to work at their locations. This inspection report focuses on the way in which care was provided for people in their own homes.

The service can provide assistance for adults of all ages including people with a physical disability, sensory needs, mental health issues and a learning disability. It can also provide care for people who live with dementia, who misuse drugs and alcohol and people who are receiving palliative care at the end of their lives. At the time of our inspection the service was not providing any nursing care. Most of the 40 people who were receiving assistance were older people. The service had its office in Maidstone and covered Maidstone, Staplehurst, Tunbridge Wells and surrounding areas.

The service was owned and operated by a company. There was a business support manager who was based at the company’s head office in Canterbury and who supervised the operation of a number of the company’s services. There was also a registered manager in post who was based at the service in Maidstone and was who was responsible for its day to day management. 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

The arrangements to ensure that there were enough staff were not always robust and staff had not consistently helped people to safely manage their medicines. Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse and had been assisted to avoid the risk of accidents. Background checks had been completed for new staff.

Staff had received training and guidance and they knew how to support people in the right way. People had been assisted to eat and drink enough and they had been supported to receive all of the healthcare assistance they needed.

The Care Quality Commission (CQC) is required by law to monitor how registered persons apply the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this subject and this enabled them to help people make decisions for themselves. When people lacked the capacity to make their own decisions the principles of the Mental Capacity Act 2005 and codes of practice were followed. This helped to protect people’s rights by ensuring decisions were made that were in their best interests.

People were treated with kindness and compassion. Staff recognised people’s right to privacy and promoted their dignity. Confidential information was kept private.

People had been consulted about the care they wanted to receive and they had been given all of the assistance they needed. Staff knew how to support people who lived with dementia and they recognised the importance of promoting equality and diversity. There was a system for quickly and fairly resolving complaints.

Some quality checks had not been completed regularly to ensure that people reliably received all of the care they needed. People had not been fully consulted about how best to develop the service. Staff were supported to speak out if they had any concerns, good team work was promoted and people had benefited from staff acting upon good practice guidance.