Archived: Nurseplus UK

Updated 2 August 2018

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 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 provider under the Care Act 2014.

We last inspected this provider on 17 December 2015 and we rated the service as Good.

This comprehensive inspection took place on 11 June 2018. We gave the provider 48 hours' notice of the inspection visit because we needed to be sure the manager, staff and people we needed to speak to were available.

We visited the office location to see the manager and office staff and to review care plans and records relating to the management of the service. During the inspection process we spoke with the acting manager, the quality assurance manager, the homecare co-ordinator, four care staff and the training co-ordinator. We also spoke to a GP who had contact with the provider. People were offered the choice to speak with us, but preferred for us to speak with their representatives. We spoke to one relative by telephone so that we could further understand their experiences. We have included their feedback in the main body of the report.

The inspection team consisted of two inspectors. Prior to the inspection, we gathered and reviewed information we held about the provider. This included notifications from the service. We used information the provider sent us in the Provider Information Return (PIR). This is 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. This included feedback from service users gathered through a questionnaire. We looked at two people’s care plans, two staff files, staff training records, policies and procedures, quality assurance documentation, audits and action plans, health and safety assessments, staff and service user feedback and information and policies in relation to people's medicines.

Updated 2 August 2018

Nurse Plus & Carer Plus (UK) Ltd in Chichester is a domiciliary care agency registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older people, people with a learning disability, physical disability, people living with a mental health condition, dementia, sensory needs or people who misuse drugs and alcohol. Not everyone using Nurse Plus in Chichester receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care which means help with tasks related to personal hygiene and eating. Where people receive personal care we also take into account any wider social care provided. At the time of our inspection, two people were supported with their personal care needs by the provider.

At our last inspection in December 2015 we rated the service as Good. At this comprehensive inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Quality systems and audits were in place to monitor the service people received. We found audits had not identified some discrepancies in care plan documentation relating to the Mental Capacity Act 2005 and the recording of staff competency assessments. Quality processes had not identified aspects of the care plans that required improvement, such as recording activities, and changes in people’s needs such as deterioration in health and/or mobility. The provider recognised these areas needed to be addressed. The impact of this was reduced due to the size of the current service.

Good systems and processes to keep people safe had been maintained. Risks to people had been identified and assessed on a regular basis. Staff received guidance on what actions to take to manage risk to help ensure people were safe. The provider had a lone worker policy to ensure staff were kept safe in the community.

People continued to be protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and followed the procedure regards what action to take to keep people safe. A relative told us, “They are really good. They do keep her safe and comfortable.”

The acting manager ensured that when new staff were employed appropriate recruitment practices continued to be followed. Staff received an induction and ongoing training and were supported to undertake additional training they identified. Staff were supported to work towards a National Vocational Qualification (NVQ) and the Provided funded their study. Staff told us they had regular supervision and appraisal as well as contact with each other. Staff told us they felt well supported by the acting manager and the wider management team. One member of staff told us, “I really enjoy working for Nurse Plus, they stick to the book and do things the right way, I feel quite proud to work for them.”

People were supported to maintain their health and had assistance to access health care services when they needed to. Staff supported people by arranging healthcare appointments for them. A GP told us that when carers had concerns about people’s health they were contacted appropriately. People were supported to receive their medicines safely by staff that were trained in administering medicines.

One relative told us the provider was caring and kind, “They are very patient with her. They understand it’s frustrating for her, and they are very empathetic.” Staff understood the person's emotional and health needs as well as their social history and this was reflected in the care plan. Staff supported people to have choices over food and drink. People were supported to remain as independent in their home as possible. One member of staff said, “If she wants help she’ll let us know. She’ll do her teeth and her hair; again, if she needs help she’ll call us.”

People's care and support was planned to meet their needs, at the time they wanted and staff arrived when expected. There had been no complaints at the service in the previous 12 months. People were confident their concerns would be responded to and knew how to raise any concerns and make complaints if needed. People were supported to pursue activities and interests that were important to them.

A relative and care staff told us the service was well managed. The acting manager was supported by a quality assurance manager and a homecare co-ordinator. The acting manager understood their responsibilities in relation to registration with the CQC. Staff told us they felt supported by the management team and there were clear lines of responsibility and accountability. Staff achievement was recognised and encouraged. We saw that the provider sought people's views on the quality of the service during annual reviews and satisfaction surveys.

Further information is in the detailed findings below.