Nurtured Care NE

Updated 8 July 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and 2 Experts 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 and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service notice of the inspection. This was because we needed to be sure that the appropriate staff would be in the office to support the inspection.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We requested feedback from the local authorities that work with the service. We reviewed the information we held about the service and used this information to plan our inspection.

During the inspection

We spoke with 10 people who received care and 12 relatives about their experience of the service. We spoke with 4 members of staff including the registered manager, quality assurance manager, and human resources manager. We were in contact with 16 members of care staff via email. We reviewed a range of records. This included 8 people's care records and 7 people's medication records. We looked at 4 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.

The inspection commenced on 9 May 2023 and 14 June 2023.

Updated 8 July 2023

About the service

Nurtured Care NE is a domiciliary care agency providing personal care to people in their own homes. They also support some people in support living care settings. At the time of our inspection there were 260 people using the service. 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.

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

Medicines were not always managed safely. Some people were receiving time sensitive medicines too close together. Medicines documents were not always completed correctly. Some risks to people such as moving and handling risks were not full assessed and mitigations were not always put in place.

Robust quality assurance processes were not always in place. Some audits were in place but had not identified some of the issues we found during inspection. Opportunities to learn lessons and improve the service were not always taken, we have made a recommendation about this.

The provider employed sufficient staff who were trained appropriately. Some recruitment records were not in line with best practice, we have made a recommendation about this. Staff worked effectively with other healthcare professionals. Infection control measures were in place.

People were safe from the risk of abuse. Risks to people were assessed and regularly reviewed when people's needs changed. The building was well maintained, and health and safety risks were assessed.

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 said the management team were supportive. People and relatives thought the service was managed well most of the time.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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 this service was good (published 17 August 2020).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, safeguarding and the management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nurtured Care NE on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, risk assessments and quality assurance processes.

We have made recommendations about staff recruitment records and incident recording.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.