What life is like for people using this service:

People continued to receive safe care. Staff knew how to keep people safe from harm and people told us they felt safe. There were enough staff to support people safely. People told us they were supported by consistent staff and received their medicines on time and in the right way. Staff had received training in infection control and had access to personal protective equipment. Accidents and incidents were noted and trends were monitored.

People continued to receive effective care, from a small team of staff who were, skilled and competent in meeting people’s individual needs. 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 support this practice. Staff supported people to maintain a healthy diet, in line with their assessed needs, and to access health care if this was needed.

People received care from staff who were kind and caring. People had positive relationships with staff and were confident in the service to be able to meet their needs in a kind and compassionate way. People were supported and encouraged by staff to make decisions as to how their needs were met. Staff understood the importance of respecting people’s privacy dignity and independence.

Staff continued to support people in a responsive way. Assessments and support plans were in place which identified what was important to people and how they should be supported. The support people received was centred around them, and they were involved in any decisions made. The provider had systems in place to resolve complaints appropriately. The service needed to develop their approach toward end of life care. We have made recommendations about complaints and end of life care.

The service continued to be well managed. The registered manager was approachable and people knew them well. Spot checks and audits were completed to ensure the quality of the service was maintained. There was a strong value base to ensure that workers were caring and compassionate. People, and their family members were actively encouraged to provide feedback on the service and staff worked well as a team in an open and supportive manner. Everyone spoke positively about the service and the quality of the support being provided.

More information is in the detailed findings below.

Rating at last inspection: Good (06/04/2016)

About the service: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to adults, younger adults who may have had a learning disability or autism. At the time of the inspection 26 people were using the service. The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive, and will inspect the service again, if we receive information that indicates risk.

This inspection took place on the 6 of April 2016 and was announced. The inspection was carried out by one adult social care inspector.

Nexus Support Ltd is a service which provides personal care and support to adults in their own homes. Some of the people using the service had complex needs and the frequency of visits depended on people’s individual requirements. Visits ranged from shorter visits of around 5 hours to 24 hour care. On the day of our inspection 22 people were using the service. Nexus supports people to undertake other activities, which could be anything from helping people to budget their finances or going out for day trips or holidays. This element of the service although provided by Nexus Support Ltd would not need to be registered with the Commission if this was their sole purpose. Because of this we have focussed our inspection on the people in receipt of personal care only.

There is a Registered Manager at this location. 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 were kept safe by staff that had a thorough understanding of their responsibilities to protect people they were caring for from harm or abuse.

People’s needs were met and they were cared for by sufficient numbers of staff. The risks to people were identified and reviewed to ensure people remained safe. People received their medicines as prescribed and the management of medicines was safe.

People had positive relationships with their care workers and were confident in the service. There was a strong value base to ensure that workers were caring and compassionate. Family members’ of people who used the service felt they were treated with kindness and said that their privacy and dignity were always respected.

Staff spoke positively about how the service was being managed and thought the service was well led. Staff members interacted with the people they were supporting in a professional, caring and friendly manner. All of the family members we spoke with were positive about the service and the quality of the support being provided.

People, who used the service, or their representatives, were actively encouraged to contribute to the planning of their care. Innovative methods were used to communicate with people who used the service and their families to promote involvement in care planning and delivery. People who used the service felt able to make requests and express their opinions and views which were acted upon.

People, and their family members, were actively encouraged to provide feedback on the service and staff worked well as a team in an open and supportive manner. Staff felt fully supported and motivated by the management team to provide a high quality service to people.