The Ryan Medical Centre Tender Nursing Care

Updated 5 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was undertaken by one adult social care inspector.

Service and service type: Tender Nursing Care is a domiciliary care agency. It provides nursing and personal care to people living in their own homes who require end of life care. The Care Quality Commission does not regulate premises used for domiciliary care; this inspection looked at people's care and support.

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: We gave the service 5 days’ notice of the inspection. This was because the service is run from the same office as the administration staff employed by the Ryan medical centre and therefore to protect confidentiality it was necessary to book a separate facility for the purpose of the inspection.

What we did: Prior to our inspection we looked at all of the information we held about the service. This included any concerns, investigations or feedback. We also checked the statutory notifications the service is required to send to us by law. We asked for feedback from professionals about their views of the service. We also looked at the Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used a planning tool to collate all this evidence and information prior to visiting the service.

During our inspection we visited, with their agreement, two people in the community. We spoke with four relatives and six staff members. These included five nursing or care staff and the registered manager, who took overall responsibility for the service. We looked at a variety of records. These included two care files, four staff personnel records, audits, policies and procedures and records relating to the operation and oversight of the service.

Updated 5 March 2019

About the service: Tender Nursing care is a charitable organisation. It is a domiciliary care service, which provides support for those in the community who require end of life nursing and personal care. The agency office is located in the Ryan Medical Centre in Bamber Bridge. It is easily accessible by public transport and a car park is available. At the time of our inspection there were nine people who used the service.

People’s experience of using this service: People told us they felt safe using the service and were kept informed and up-to-date in relation to their family members care. They said care and support was delivered in a way they wanted it to be. They felt involved and were certain their loved one's needs were being met by kind and caring staff. One person told us, "We are very happy with the service and the carers who come here. They are very good indeed. We have no complaints. They are very pleasant and respect my wife as a person. We get the same staff all the time, who have very good attitudes."

Since the last inspection a good range of improved documentation had been introduced, which had enhanced the practices adopted by the service.’Systems to act on allegations of abuse were in place. Risks in general had been managed.

There were no reported accidents or incidents, but a system was in place to record these, should it be necessary. Relatives of the people we visited took on the responsibility of the management of medicines. However, staff had received training in medication awareness and guidance for staff was available. Staff were recruited safely and there was a consistent staff team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's needs and choices were assessed and their care and support was delivered to achieve effective outcomes. Staff engaged with people and we were told care workers were kind and caring.

New staff received an induction programme and completed shadow shifts before commencing lone working. A broad range of training had been completed by all staff, who were regularly supervised and appraised each year.

Detailed information was recorded in daily diaries, which demonstrated people were provided with person centred care and support plans were available in people’s homes. A system was in place for the management of complaints.

Some audits had taken place and feedback was regularly obtained from those who used the service and their relatives. Senior oversight was ongoing to provide support and drive improvements forward. Team meetings were taking place.

Rating at last inspection: The last inspection was rated good in all key questions and good overall. The report was published on 30 August 2016.

Why we inspected: This was a scheduled inspection based on the previous ratings.

Follow up: The service will be re-inspected as per our inspection programme. We will continue to monitor any information we receive about the service. We may bring the next inspection forward if we receive any concerning information.