We were unable to talk to people who used the service as part of this inspection. We found that nurses were self employed and contracted by the service to work on film sets as required. We talked to nurses who worked for Millstream nursing, they told us how they would ensure people are treated with privacy and dignity and that where a treatment room was available, this would be used and as a minimum people would be taken to a quiet area where conversations could not be overheard. We were told that nurses are required to carry their own first aid kit and emergency medicines there was no guidance on what medication should be held by the nurses. We were told that the nurses were responsible for keeping themselves up to date with professional development and that the service did not provide training to the them; nurses, were not up to date with all relevant training. Care records were not always completed to the required standard. We found evidence that incidents were recorded and reported although the correct forms were not used in some instances.
Nurses we spoke to were confident in their ability and experience, however, documentation was, in general, not maintained to the level required. The service did not have systems in place to monitor the quality of the care and treatment provided.