About the service:

Fisher Healthcare East Anglia Ltd is a domiciliary care service based in Norwich, providing care in Norwich and the surrounding areas, primarily to older people.

At the time of the inspection, the service was providing personal care to 38 people living in their own homes and there were 28 staff.

Fisher Healthcare East Anglia Ltd is a new franchise of Fisher Healthcare Ltd and took over the service provision from Fisher Healthcare Ltd in January 2018.

Fisher Healthcare East Anglia Ltd had also established a second branch in Suffolk to provide a similar service which had yet to be registered with the Care Quality Commission. They agreed to also apply to register this location and its manager by the end of March 2019. This separate location was not inspected as part of this inspection; but will be inspected once appropriately registered.

People’s experience of using this service:

Fisher Healthcare East Anglia Ltd had recently experienced a period of instability related to difficulties with poor performance of its management team. The provider had resolved this through major changes to the management team which occurred three months prior this inspection. The new management team has since been working to make improvements.

All the stakeholders involved, including people using the service, staff and commissioner had faith in the new management’s open approach and their ability to return to providing high quality care.

The new management initially needed to prioritise ensuring delivery of care and stabilising the staff team; alongside this work they then reduced its service provision through appropriately serving notice to unsustainable packages of care. Whilst they had ensured they met all their commitments to provide care in this period, the management team acknowledged prioritising provision of care meant they had neglected other aspects of governance.

People usually received their medicines when they needed them. However, medicines administration records were not always completed fully and the management were significantly behind with auditing the medicines administrations records, so could not be sure safe practice was being maintained.

Care reviews were not always being completed with appropriate frequency to identify potential changes in needs and desired outcomes.

Risks to people’s individual safety had usually, but not consistently, been assessed. However, staff acted to reduce risk wherever possible and were knowledgeable about how to support people to remain safe from abuse or harm.

People received support to maintain their health when needed and the care they received enhanced their wellbeing.

Care plans were appropriately person-centred and care practice reflected good knowledge and understanding of people’s needs.

Feedback from people using the service was positive, both about the quality of the care provided and the new management team.

The provider operated safe recruitment practices and now had sufficient staff to ensure people received the care they needed. Staff were suitably trained and skilled to provide safe and effective care that met people’s needs and preferences.

Rating at last inspection:

Fisher Healthcare East Anglia Ltd was a new legal entity and as such had not previously been inspected or given a rating.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people received safe, compassionate, high quality care.

Future inspections will be carried out to enable us to have an overview of the service; we will use this inspection and information we receive to inform future inspection timescales.

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