Nissi Home Care

Updated 2 July 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by one inspector and two Experts by Experience who spoke with people and relatives by telephone for feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information gathered as part of monitoring activity that took place on 15 March 2022 to help plan the inspection and inform our judgements. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and 10 relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager and support workers.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at six staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures, management audits, complaints, staff rotas and meeting minutes, were reviewed.

Updated 2 July 2022

About the service

Nissi Home Care is a domiciliary care service that provides care and support to a wide range of people with varied needs, including older people, younger adults, people with dementia and people with a physical disability. The service also provides end of life care and support to a number of people. At the time of our visit 37 people living in several parts of London were using the service.

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.

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

Whilst people and their relatives told us staff were kind, caring and competent, the service did not complete all the required recruitment checks appropriately before staff were employed.

Staff had the right training and were competent to administer people’s medicines as prescribed. The service identified risks associated with people’s care and health needs and provided guidance for staff to reduce those risks. People felt safe and were protected from abuse. Staff were aware of their responsibilities to raise concerns if they felt a person was being abused. The service understood the importance of infection prevention and control and had measures in place to keep people safe.

The service had systems in place to monitor and improve the quality of service. However, existing audits had not identified the concerns we found during this inspection. The registered manager reacted promptly and started making improvements.

There was a positive and inclusive culture at the service where people and their relatives felt valued and respected. People and their relatives were able to express their views which staff acknowledged. Staff felt supported in their roles and provided care that was tailored to meet people’s individual needs. The service worked in partnership with other organisations to support people and their relatives in their best interests.

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 25 October 2018).

Why we inspected

We undertook this focused inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to safe recruitment of staff.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.