About the service:

Nexxus Care (Staffordshire) is a domiciliary care service that was providing personal care to 79 people living in their own homes at the time of the inspection. People had a range of support needs such as people living with dementia or those who needed support with their mental health, older and younger adults, people with a learning disability and a physical and/or sensory impairment.

The service was split into two parts; reablement and domiciliary care. For those receiving reablement support, this was short package of care, typically lasting up to six weeks, to help people be more independent and to make improvements following coming home from hospital. Those in receipt of a domiciliary care needed longer term support to help them remain in their own homes.

People’s experience of using this service:

Systems were not always effective at identifying omissions and the monitoring of people’s experience of care was inconsistent. Notifications to the CQC were not always submitted as required. Some staff were confused about the management structure, however staff who did know the registered manager felt they were approachable.

There were not always enough staff which mean staff were having to cover additional calls. People liked their regular staff and felt treated with kindness and respect; however, people were not always supported by the same staff team. Improvements were needed in ensuring recruitment information was available.

People were supported to take their medicines but improvements were needed to ‘as and when required’ medicines and the recording of nutritional supplements.

There was mixed feedback about staff training, although plans were already in place to make the necessary improvements. There was also mixed feedback about how people were supported with their food and drinks.

People were supported to access other health professionals but improvements were needed to the information available to staff about people’s specific health conditions.

Appropriate assessments were not in place to ensure people had the mental capacity to make certain decisions, although people did not raise concerns about being offered choices.

Care plans did not always contain information about people’s end of life preferences and the reviews of people’s care plans was inconsistent.

People were supported to retain and regain their independence. People felt able to complain, and complaints were responded to.

The service worked in partnership with other organisations. The provider was proactive in trying to improve the service and following feedback action was taken and plans were put in place to take further actions.

People were protected as staff understood their safeguarding responsibilities and following infection control procedures.

Rating at last inspection:

This is the first time the service has been inspected since registration.

Why we inspected:

This was a routine inspection planned on when the service was registered.

Recommendations:

• We have recommended staff are supported to improve their understanding of the Mental Capacity Act 2005.

Enforcement:

Action we told the provider to take can be seen at the end of the full version of the report.

Follow up:

We will continue to monitor the service and check improvements have been made at our next inspection.