Archived: Your Care and Support Northampton Also known as Complete Nursing and Care Solutions

About the service

Your Care and Support Northampton is a domiciliary care agency providing personal care to people living in their own homes.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of inspection, 61 people were receiving support with personal care.

People’s experience of using this service and what we found

People’s risks had been assessed, however the provider did not have plans in place to mitigate all risks identified or provide enough guidance for staff to ensure people were supported safely.

There was not always enough staff to meet the needs of people using the service. People had frequently experienced late and missed calls and were at risk of neglect where care had not been provided.

We found gaps in medicine records and we could not be assured people were receiving their medicines as prescribed.

People were not always supported with eating and drinking. Visits to support people with preparing meals and drinks had been missed, this had also affected people that needed to take their medicines with food.

Systems and processes in place were not effective in identifying areas where improvements were needed within the service. Audits and quality assurance tools were not robust enough to drive improvement or provide enough oversight of the service.

People did not feel complaints were always acted upon. The provider had acknowledged this and had prioritised their focus on resolving issues and concerns raised.

Staff were not always receiving supervision or competency checks to support them in carrying out their role effectively. Staff told us how inconsistencies in communication from management and pressures on staffing had affected staff morale. Some improvement had been made, however this was not yet consistent or embedded into the service.

Staff were aware of how to identify and report any signs of abuse to safeguard people from harm.

People were supported by staff that were recruited safely and had received mandatory training as part of their induction to support their role.

People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider was in the initial stages of implementing changes to improve service delivery, following recent concerns raised. Actions had been taken and were ongoing to recognise changes needed, to support staff and to improve people’s experience of care. This was not yet embedded into the service to demonstrate its effectiveness.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 13 September 2018).

Why we inspected

We received concerns in relation to the management of the service, staffing, missed or late calls, outdated care plans and missed medicines. As a result, we undertook a focused inspection to review the Key Questions of Safe, Effective and Well-led only.

The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Your Care and Support Northampton on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, meeting nutritional and hydration needs of people, staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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Not everyone using Your Care and Support Northampton receives the regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection,34 people were receiving personal care.

This inspection took place on the 29,30 and 31 August 2018. This was the first comprehensive inspection for the service since it registered with the CQC in September 2017.

The provider was also the registered manager at the time of our inspection. A registered manager is a person who has registered with the CQC 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 received care from staff that were friendly, kind and caring; passionate about providing the care and support people needed and wanted to enable them to stay in their own homes. People felt cared for safely in their own home.

Staff had the skills and knowledge to provide the care and support people needed and were supported by a provider who was visible and approachable, receptive to ideas and committed to providing a high standard of care.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

People's health and well-being was monitored by staff and they were supported to access health professionals in a timely manner when they needed to. People were supported to have sufficient amounts to eat and drink to maintain a balanced diet. People experienced caring relationships with staff and good interaction was evident.

Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns. Care plans contained risk assessments which gave instructions to staff as to how to mitigate risks; these enabled and empowered people to live as independent a life as possible safely.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005). The provider was aware of how to make referrals to the Court of Protection if people lacked capacity to consent to aspects of their care and support and were being deprived of their liberty.

The provider continually monitored the quality of the service provided. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to and acted upon.