Background to this inspection
Updated
25 January 2020
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 team consisted of two adult social care inspectors. One adult social care inspector undertook the site visit and the other made telephone calls to relatives.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 18 December 2019 and ended on 3 January 2020. We visited the office location on 18 December 2020.
What we did before the inspection
We reviewed information we had received about the service since they were registered. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return 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 took this into account when we inspected the service and made the judgements in this report.
During the inspection
We did not speak with people who used the service as the provider told us they would be unable to speak with us due to the complexity of their needs. We contacted four relatives across a number of days to find out about their experience of the care provided. Some relatives declined to provide us feedback and other relatives did not answer the telephone. We sent emails to professionals who work alongside the service for feedback. We spoke with four members of staff including the registered manager, lead nurse, complex care associate and a healthcare assistant.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at further medicine records and mental capacity assessments.
Updated
25 January 2020
About the service
Newcross Healthcare Solutions Limited (Shrewsbury) is a domiciliary care agency providing staff to work in care homes and personal care and support to people in their own homes. The service currently supports younger disabled adults and children. At the time of inspection, the service was providing support to 4 people.
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. We did not inspect the part of the service that supplies staff to care homes as this is not a regulated activity.
People’s experience of using this service and what we found
People were safe. Effective systems were in place to protect people from abuse and staff understood how to keep them safe. Accidents and incidents were investigated and action taken to address any concerns. People’s risks were assessed and managed effectively. Where people presented with behaviours that challenge, triggers were identified and risk assessments guided staff how to manage the behaviour. People were supported by a sufficient number of safely recruited staff. Medicines were stored and administered safely and clear protocols were in place to guide staff when to administer ‘as required’ medicine. Staff wore gloves and aprons and understood how to manage the risk of infection. Where things went wrong, the provider immediately addressed concerns and took steps to reduce the risk of reoccurrence.
People’s needs were assessed in a personalised way and care was delivered in line with their needs. Staff were skilled and knowledgeable and were trained specifically to meet the care needs of the individuals they supported. People were supported to eat and drink in line with their care plans. People were supported by staff who worked seamlessly with other care providers to provide consistent care. People were supported to access healthcare professionals when needed and their oral health needs were met.
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 were kind and caring and spoke with empathy about people they supported. People were supported to make their own decisions about care. People were supported by staff who understood how to promote their dignity and independence.
People’s care plans were personalised and guided staff how to support people in line with their needs and preferences. People’s communication needs were identified, and staff supported people in line with their needs. People were supported to engage in activities of their choice both in the community and at home. Complaints were investigated and action taken where needed. People’s end of life wishes were discussed with them and their relatives and advanced care plans were in place when appropriate.
The provider and registered manager strongly promoted person centred care to improve people’s quality of life that was reflected throughout the service. The registered manager understood the duty of candour and promoted an open and honest environment. Effective audit systems were in place to check the quality of the service and action was taken to address any concerns identified by audits. Audits were reviewed by the head office clinical governance team to provide further quality checks. Staff were clear about their roles and had good management support throughout the service. Relatives and staff were encouraged to provide feedback regarding the service and an open-door policy was promoted. The provider and registered manager placed an emphasis on continuously improving the service. The service worked closely with other care providers and healthcare professionals to meet people’s needs.
For more details, please see the full report which is on the CQC website at
Rating at last inspection
This service was registered with us on 15 January 2018 and this is the first inspection.
Why we inspected
This was a planned inspection as the service had not yet been inspected.
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.