Agincare UK - Nutfield Extra Care Scheme

Agincare UK - Nutfield Extra Care Scheme provides personal care to people living in their own flats across four schemes. It also provided personal care services to those people who were in prison. At the time of our inspection there were 74 people using the service.

The service was managed by a registered manager. 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.

People told us they felt safe when using this service. Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns. Risks to people's wellbeing were assessed and action taken to reduce these. The service focused on keeping people safe whilst promoting their independence.

There were enough staff to meet people's needs and staffing levels were flexible according to people's changing needs. The registered manager followed safe recruitment practices to ensure that staff were suitable to work with people. Staff were qualified and received training that helped them to deliver a high quality service to people. The registered manager provided support and guidance to staff to ensure they were equipped to carry out their roles. Staff felt valued by the registered manager and supported in their roles.

People’s medicines were handled safely.

Where necessary people's nutritional needs were well met. Where required they supported people to access a range of health and social care professionals in the community for advice, treatment and support. Staff monitored people's health and wellbeing and responded quickly to any concerns.

Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. Staff had a good understanding of people's needs and supported them effectively.

People's achievements were celebrated and their views were sought and acted on. People were supported by staff who were compassionate and treated them with dignity and respect. Without exception, people who used the service spoke highly in their praise about the staff who supported them.

People had assessments of their needs and care was planned and delivered in a person-centred way. The service had creative ways of ensuring people led fulfilling lives and they were supported to make choices and have control of their lives.

People described how their care was delivered and what they told us demonstrated the service was extremely person-centred. Staff echoed that the service was person-centred in their feedback and our own observations and evidence gathered supported this. Every element of the approach of the registered manager and staff was centred around the person who used the service, their abilities, feelings, wishes and goals.

People who used the service accessed a range of community facilities and were involved with activities which were organised by the service.

People's end of life wishes were followed with pride and staff took great comfort when they had supported people to have the end of life they had wished for.

The service had a positive, vibrant and caring culture which people, relatives and staff supported and promoted. People told us they were well supported and well cared for. Staff were exceptional in supporting people to be as independent as possible in their lives. We saw lots of examples where people were striving towards independence.

Staff were highly motivated and reflected pride in their work. They talked about people in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care possible for each person.

The registered manager provided exceptionally strong, clear leadership and ensured an enabling and person centred culture was firmly embedded in the service. People, relatives, professionals and staff spoke very highly of the leadership, and held the registered manager in high regard. There was a clear commitment to put people at the heart of the service, by empowering and working in partnership with health and social care professionals.

This inspection took place on 24 August 2017 and was announced. We announced the inspection because we needed to be sure somebody would be present at the location. At the previous inspection we found a breach of Regulation 9 (Person-Centred Care). During this inspection we found that improvements had been made and the provider met this legal requirement.

Agincare UK - Nutfield Extra Care Scheme provides personal care to people living at the on-site 'Extra Care Scheme' as well as people who are detained at HMP Leyhill. The purpose of this inspection was to look at the care provided to people at HMP Leyhill. The service had a registered manager. 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.

We found that people had detailed and up to date care plans in place, which they had been fully involved in creating. Care staff kept daily records which confirmed that they had provided the care people required. Care staff communicated any changes in people's needs, health and well being to the appropriate people.

People said that they had been involved in developing their care plans and that they had consented to the care and support in their care plans. There were suitable arrangements to manage medication to keep people safe. One person told us that the staff helped them so that they had the right tablets at the right time.

The staff had had regular supervision and spot checks from a senior to make sure they were working effectively and they were supported. When they started work they had all the basic training needed to make sure that they had the skills to work with people. Staff had the opportunity to work towards qualifications in care. They received more specialised training to keep their qualifications and skills up-to-date.

Three people told us that the staff had the right skills and training to meet their needs. Two people told us that the staff were all very good. Another person said that the staff were very encouraging and helped to promote their independence. One person said that 'they always know what they are doing' and the care and support from staff was 'spot on.' Another person said that the staff 'cannot do enough for you.' A third person said that they 'could not ask for better.'

There were arrangements to monitor the quality of the service provided and people told us that they were asked for their views about the service. There were also arrangements to make sure that risks were managed and people were kept safe.

People told us that they were satisfied with the service they received. Care plans were person centred and up to date. One person told us they felt confident that care staff would arrive on time and provide the care they needed. This person told us that if they pressed their emergency alarm the staff would attend immediately.

People told us they felt safe with the care staff and knew who to talk to if they had any concerns. Staff told us they were confident the manager would take action in response to any concerns or complaints.

The service ensured that effective recruitment procedures were in place so that people were safe.

The provider had a system in place to monitor the quality of the service.