About the service:

Agincare UK Nott's County provides personal care in people's homes to adults of all ages with a range of care needs. The service currently has 76 people registered to use the service, living in and around Nottinghamshire and Nottingham city centre.

People’s experience of using this service:

¿ People felt safe and the service assessed risks to the health and wellbeing of people who use the service and staff. Where risks were identified action was taken to reduce the risk where

possible.

¿Recruitment processes were in place to make sure, that people were protected from staff being employed who were not suitable.

¿Medicines were handled safely by staff who had been assessed as competent to do so. Although we gave the provider guidance about how to improve this in their documentation; in order to ensure clarity in care plans and daily records when this was administered or prompted for people by staff.

¿People received effective care from staff who were well trained and supervised.

¿People felt the service they received helped them to maintain their independence where

possible.

¿People said that staff were caring and respected their privacy and dignity.

¿People received care that was planned with them to meet their individual needs and preferences.

¿ People told us they did not always receive their calls at the time allocated to them, as staff were not always punctual for their visits. We saw that the provider had put measures in place to address this with an electronic call time monitoring system. We were assured that the provider had made improvements to maintain accurate call times using this method, and by the employment of 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 knew how to complain and knew the process to follow if they had concerns.

¿People's right to confidentiality was protected and their diversity needs were identified and

incorporated into their care plans where applicable.

Rating at last inspection:

The service was previously inspected on 22/09/16 and was rated as ‘Good’.

Why we inspected:

This was a planned comprehensive inspection in line with our inspection programme.

Follow up:

We will continue to monitor all information we receive about this service. This informs our ongoing

assessment of their risk profile and ensures we are able to schedule the next inspection accordingly.

This inspection took place on 19 July 2016 and was announced.

Agincare Notts County provides personal care in people’s homes to adults of all ages with a range of health care needs. On the day of our inspection around 300 people were using the service, living in and around Nottinghamshire and Nottingham city centre.

At the time of our inspection, the registered manager had recently left and the provider had appointed a replacement who had recently started work but had still to make their application to CQC to become the 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 who used the service and those supporting them knew who to report any concerns to if they felt they or others had been the victim of abuse. Risks to people’s health and safety were managed and detailed plans were in place to enable staff to support people safely. Accidents and incidents were investigated.

There were enough staff to ensure that people received their calls at the planned time and meet their care needs. Where required, people received the support they needed to safely manage their medicines.

Staff were provided with the knowledge and skills to care for people effectively and received supervision of their work.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The provider was aware of the principles of the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

Where people required support to eat and drink enough, this support was provided. Staff made sure that people had access to their GP and other health care professionals when needed

Positive and caring relationships had been developed between staff and people who used the service. People were involved in the planning and reviewing of their care and making decisions about what care they wanted. People were treated with dignity and respect by staff who understood the importance of this.

People’s care plans provided comprehensive information about their basic care needs and were regularly reviewed and updated. However, care plans did not always contain such detailed information about any specific medical conditions people may have and the implications of this for the support being provided. People felt able to make a complaint and knew how to do so.

The culture of the service was open. People were supported by staff who were clear about what was expected of them and staff had confidence that they would get the support they needed, both during and outside of office hours. People and staff were asked for their opinions about the quality of the service. The manager ensured that audits were undertaken and practice observed to ensure that the care provided met people’s needs.

This inspection took place on 18 March 2015 and was announced. Agincare Notts County provides personal care in people’s homes to adults of all ages with a range of health care needs. There were approximately 350 people using the service at the time of the inspection.

The service has 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.

Staff had completed training in how to keep people safe and had access to guidance however some people did not feel safe. Staff were able to recognise if people were at risk and knew what action they should take. The registered manager had taken action when people had been identified as at risk and learning had taken place. People had risk assessments and where risks had been identified there were plans to manage them effectively. Staff understood risks to people and followed guidance. Staff were alert to changes in people’s usual presentation. They recorded incidents and reported them.

There were sufficient staff to provide people’s care however the staff providing care to people was not always consistent. Comprehensive pre-employment checks had been carried out.

People’s care was provided by staff who were sufficiently trained and supported. Staff had received an induction when they started employment with the provider and further training relevant to people’s needs had been provided to undertake professional qualifications. Systems were in place to support staff and monitor their work for example medicines training and medicines competency checks were carried out, however medicines were not recorded appropriately.

People were treated with dignity and respect. Where people lacked the capacity to consent to their care relevant guidance had been followed. The provider was aware of anyone who was legally appointed to make decisions for people.

People’s needs in relation to nutrition and hydration were documented. People received appropriate support to ensure they received sufficient to eat.

Care plans were personalised and people were supported to maintain their choices. However care plans were not always updated.

People’s feedback on the service was sought through telephone calls and visits. People’s views had also been sought through the annual quality survey. People had information and support to make complaints. Where complaints were made they were investigated and actions taken in response. Complaints were analysed for themes however where these had been identified action had not always resolved the issue.

There had been a change in the ownership of the company providing the service and management in the past six months. Staff were supported by the new leadership and staff were encouraged to speak with the office about any concerns they had about people’s care. The new management understood the challenges facing the service in relation to managed growth and staffing. There were measures in place to support growth. There were systems in place for the provider to receive reports on the quality of the service provided however this had not consistently improved the service.