Archived: NurseplusUK

Updated 4 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is 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.

Inspection team: This inspection was carried out by one adult social care 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:

Nurseplus UK is the Cornwall branch of a national agency providing care and support to people in their own homes and supported living. Services include care for those with; dementia, eating disorders, learning disabilities, mental health conditions, sensory impairments.

The agency is registered for Personal Care and Treatment of disease, Disorder or Injury, caring for children (0 to 18 years), and caring for adults of all ages.

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:

This inspection was announced. We gave the service 24 hours’ notice of the inspection visit in line with our methodology for inspection domiciliary services. This ensures there are appropriate people available at the office to provide necessary information to us.

We visited the service on the 20 February 2019 and looked at records, spoke with the registered manager and two office staff. We visited one person in their own home. Prior to the inspection we spoke with five relatives of people who received a service. After the inspection we spoke with one

Person.

What we did:

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us by other agencies.

During the inspection, we had discussions with the registered manager and two office staff. We looked at the care and medication records of three people who used the service, we also examined records in relation to the management of the service such as staff recruitment files, quality assurance checks, staff training and supervision records, safe guarding information and accidents and incident information.

Updated 4 April 2019

About the service:

Nurseplus UK is a domiciliary care agency that provides personal care to people living in their own homes in the community. When we inspected they were providing the regulated activity, personal care, to 14 people in the Truro and surrounding areas in Cornwall.

The service provides care to people of all ages with a variety of care needs, such as learning disability, mental health, dementia and sensory needs. Staff supported people to access the local community, do their shopping and prepared meals. Some people received 24 hour care from staff at NurseplusUK to enable them to remain safely in their own homes.

People's experience of using the service:

• People were protected from potential abuse and avoidable harm by staff that had regular safeguarding training and knew about the different types of abuse.

• Staff went above and beyond their roles as carers to ensure people were protected further from risks in their own homes.

• People received outstanding service from Nurseplus UK in relation to the risks they may be exposed to by their accommodation and their method of heating their home.

• Risks to staff working alone late in the evening had been identified.

• The registered manager had provided staff with personal emergency alarms to further protect them when working alone in the community in the evenings.

• There were sufficient numbers of staff to meet people's needs. The provider ensured people had a consistent staff team.

• Medicines were managed safely to ensure people received them safely and in accordance with their health needs and the prescriber's instructions.

• People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs. The provider had a good system to monitor all staff had regular training and refresher training to keep them up to date with best practice. Training methods included online, face to face training and competency assessments.

• Staff provided some shopping services for people. There were procedures in place to ensure that people’s money was protected and managed safely.

• Staff treated people with kindness, compassion and were respectful. Staff interacted well with people and their relatives when providing care.

• One relative told us that she lived out of county and when she visited her relative, she felt ‘she was not needed’ as the carers were so attentive.

• People, and where appropriate their representatives, were involved in decisions made about their care. The management team from Nurseplus UK had visited people prior to them receiving care visits, to discuss their care needs and to develop a care plan. Where necessary, they sought external professional help to support decision-making for people.

• The registered manager was very keen to ensure the service was as responsive to the needs of the people they supported as they could possibly be. The service was outstandingly responsive to people’s needs.

• One person told us they had only the night before, made an out of hours request for a carer to visit them the following morning to give them a shower; this was acted upon swiftly and accommodated in line with the relative’s request.

• Staff knew the people they supported well, several people had had a

relationship with Nurseplus UK for many years. Staff were aware that some people were isolated and lonely alone at home. Staff put forward a suggestion that they set up the ‘Young at heart club’.

• The ‘Young at heart club’ was held in the service offices once a month and people were bought in, by staff, to enjoy tea, cake and the company of others. A variety of information and offers of support and advice would be provided at the events to further enhance their quality of life.

• There was a complaints policy and process in place which people were aware of.

• Staff were provided with specific end of life care training.

• Staff often stayed on at people’s homes supporting the families of people who had died even after their own shift had concluded.

• The registered manager recognised a member of the care staff each month for an award. This was seen as motivational and recognition of staff showing commitment to good care.

• Staff received chocolates, flowers and a certificate to evidence their good work.

• Annually a member of staff was recognised to going above and beyond the call of duty and offered a night in a hotel and a meal as a thank you.

• Everyone we spoke with about Nurseplus UK told us they thought they provided a very good effective service.

More information is in Detailed Findings below

Rating at last inspection: At the last inspection the service was rated Good. The report was published 27 September 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection the service has been found to be Outstanding

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.