18 December 2014
During a routine inspection
We inspected the service on 18 December 2014. The provider had a short amount of notice that an inspection would take place so we could ensure staff would be available to assist us.
The Nursing Relief Agency provides care and support for people living in their own home. At the time of our inspection there were 16 people using the service with a variety of needs. These included older adults, people with physical disabilities and people with dementia care needs.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At our previous inspection on 28 February 2014 we found that the provider was not meeting two regulations. These related to the numbers of staff appointed at the service and quality assurance. The provider sent us an action plan outlining how they would make improvements.
We checked for improvements during this inspection and found that the provider had made sufficient improvements to comply with these regulations.
There were sufficient numbers of staff available to ensure people’s needs were being met at an appropriate time.
There were effective systems in place to assess and monitor the quality of the service. This included gathering the views and opinions of people who used the service and monitoring the quality of service provided.
People we spoke with and their relatives told us they were satisfied with the care and support provided. They had developed good relationships with their care workers and told us they were treated with kindness and respect and felt safe using the service. People were confident that any issues or concerns they had would be responded to appropriately by the service.
Staff had a good understanding of the needs of people they cared for and were positive about their role and the organisation.
Staff recruitment procedures were robust and ensured that appropriate checks were carried out before commencing work. Staff received a thorough induction and on-going training to ensure they had up to date knowledge and skills to provide the right support for people. They also received regular supervision, appraisal and observations of their practice.
Staff were complimentary about the registered manager and had no concerns about raising issues.
People’s needs were assessed and plans were in place to meet those needs. People’s wishes and preferences were taken into account, recorded in care plans and respected during care delivery. Risks to people’s health and well-being were identified and plans were in place to manage those risks.
People were supported to access healthcare professionals whenever they needed to and their needs in relation to eating and drinking were supported. People’s medicines were managed and administered safely.
People’s consent had been appropriately obtained and recorded. However, we noted that people’s relatives had at times been asked to consent on people’s behalf when the service had not established that the person lacked capacity to do so. The registered manager understood the principles of the Mental Capacity Act and how they might apply to the people who used the service.