NCC First Support - Eastern

Updated 14 May 2019

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: One inspector and one expert by experience carried out this inspection. 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: Norfolk First Support provides personal care to people living in their homes. The service provides a comprehensive range of assessment and reablement services to enable people to regain a level of independence and live as safely as possible in their homes, or to provide support to carers to help them achieve this aim. The service is time limited for up to six weeks, where people are either discharged or longer-term care is arranged. There were 75 people using the service when we inspected.

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 visit because we needed to ensure the registered manager would be available.

What we did: We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us of and we sought feedback from the local authority. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

This was an announced, comprehensive inspection. Inspection activity started on 27 March 2019 when we visited the office premises to see the manager and office staff, and to review care records and policies and procedures. The inspection activity ended on 1 April 2019. The expert by experience spoke with 16 people who used the service, and eight relatives. These calls were carried out on the 27 and 28 March 2019.

We also spoke with the registered manager, county manager, and four reablement support workers/practitioners who worked at the service.

Prior to the inspection we spoke with the local authority safeguarding and quality assurance team. During the inspection we spoke with one social care professional and one health professional.

We looked at six care records in relation to people who used the service. This included medicines records. We also looked at three staff files as well as records relating to the management of the service, recruitment, policies and systems for monitoring quality.

Updated 14 May 2019

About the service: Norfolk First Support provides a comprehensive range of assessment and reablement services to enable people to regain a level of independence and live as safely as possible in their own homes, or to provide support to carers to help them achieve this aim. The service is time limited for up to six weeks, where people are either discharged or longer-term care is arranged.

People’s experience of using this service:

¿ People told us that care staff were kind and caring in their interactions with them, but sometimes they were not fully involved in agreeing their reablement goals. Some people also said that a full assessment of their needs had in some cases been delayed longer than the services' aim of 48 hours. People sometimes required longer than 48 hours to settle following discharge back home and so the visit was timed to maximise their ability to contribute to setting their reablement aims and goals.

¿ Auditing processes needed to be more robust and detailed to identify where improvement was needed. A registered manager was in post at the time of inspection but only worked part time which impacted on the oversight and governance of the service. Since the inspection they have been made full time.

¿ Further improvements were needed to ensure that risk assessments and care plans were sufficiently detailed so staff had clearer guidance.

¿ Staff knew how to support people and received mandatory training in their roles. However, due to the increasing complexity of people using the service, staff had requested training in more specialist areas to ensure they had the necessary skills to care for people effectively. This included mental health, end of life care, and substance misuse.

¿ People were supported to eat and drink enough to maintain a balanced diet. Further information was however required within care plans with reference to people’s dietary needs and food preferences.

¿ There were sufficient staff to cover all visits. Recruitment procedures were in place to ensure staff were suitable for their roles.

¿ People had access to healthcare professionals when required.

¿ The principles of the Mental Capacity Act (2005) were adhered to; the service had referred to social care professionals where there was doubt about a person’s mental capacity.

¿ There was a warm and friendly culture at the service. Staff felt supported and valued. The provider was committed to ensuring that improvements found would be addressed promptly.

Rating at last inspection: This was the first inspection of this service since being registered with the Care Quality Commission in March 2018.

Why we inspected: We inspected this service in line with our inspection schedule for services not yet rated.

Enforcement: Action we told the provider to take is outlined at the back of the report.

Follow up: We will continue to monitor this service according to our inspection schedule in line with the rating of ‘Requires Improvement.’

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