White Bird Care and Nursing Agency

Updated 21 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 48 hours’ notice of the inspection visit because it is small and the managers are often out of the office supporting staff or providing care and therefore we needed to be sure that they would be available.

Inspection site visit activity started on 18 January 2018 and ended on 23 January 2018, it included; speaking with people or their representatives and reviewing records. We visited the office location on 18 January 2018 to see the registered manager and the manager; and to review care records and policies and procedures. The inspection team included two adult social care inspectors.

We did not ask the provider to complete a Provider Information Return (PIR) prior to the inspection; instead, we requested this information at the inspection. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with the registered manager and a second manager who was also in the process of registering with the Care Quality Commission to manage the service provided. The registered manager and the manager were also the providers of the service. Following the inspection, we spoke with one person and one relative, in addition to two people’s social workers and one of the provider’s two care staff.

We reviewed records which included all people’s care plans, all staff recruitment and supervision records, including those of the registered manager and the manager and records relating to the management of the service.

During the inspection we asked the provider to submit additional information we required for consideration as part of the inspection process within a specified timeframe, which they supplied as agreed.

The service was last inspected on 22 December 2016 when we found four breaches of the Regulations.

Updated 21 February 2018

The inspection took place on 18 January 2018 and was announced, as it is a small service, to ensure staff we needed to speak with were available. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is also registered for nursing care but currently does not support any people who require this type of care. It provides a service to older adults, younger adults, people living with dementia or mental health needs. At the time of the inspection, the provider was supporting three young people.

The service had a registered manager and a manager who was in the process of applying to the Commission to become a second registered manager for the service. 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.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective and well-led to at least good. At the last inspection on 22 December 2016, we asked the provider to take action to make improvements in relation to breaches of regulations we found in relation to medicines, safeguarding, notifications and good governance, these actions have now been completed.

At this inspection, we found people were safeguarded from the risk of abuse. The registered manager and the manager understood their role and responsibilities to raise any safeguarding concerns for people. Records were maintained of medicines staff either administered to people or supported people to take. Staff underwent medicines training and had their medicines competency assessed regularly.

At this inspection, we found processes were in place to monitor the quality of the service people received and to seek people’s feedback in order to identify any potential areas for improvement of the service for people. The manager had since the last inspection, updated the safeguarding policy to include the requirement to inform CQC of any safeguarding alerts made to the local authority.

Risks to people had been assessed and control measures were in place to manage any identified risks. People’s risk assessments were reviewed at least annually to ensure they remained relevant.

There were sufficient numbers of suitable staff to support people and meet their needs. The provider followed safe recruitment practices for people. Processes were in place to protect people from the risk of acquiring an infection during the delivery of their care. Processes were in place to ensure any required learning could take place following an incident to ensure people’s future safety.

People’s needs were assessed prior to the commencement of the service. The manager kept themselves up to date with developments and policies reflected current guidance to ensure people received effective care.

Staff underwent an induction to their role. We have made a recommendation about the provider assuring themselves that this meets current guidance. Staff underwent a range of training and some staff completed further training immediately following the inspection to ensure they had the knowledge to provide people with effective care. Staff received regular supervision and support in their role.

Staff supported people to eat and drink sufficient for their needs. Staff had worked with health professionals to ensure people received effective care. Staff were able to support people to meet their health care needs where they required this assistance.

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 and relatives reported that staff were caring. People were treated by staff with kindness, respect and compassion during the provision of their care. People were supported to express their views and to be involved in decisions about their care and treatment as far as possible. Staff upheld and promoted people’s privacy and independence during the provision of their care.

People received personalised care based on their needs and their care was kept under regular review. Staff confirmed they received relevant information about people upon which to base people’s care. The service was responsive to changes in people’s needs. People were supported to take part in activities that were relevant to them. Processes were in place to enable people to make a complaint if required.

The registered manager needs to ensure that record keeping standards consistently meet regulatory requirements. The manager took prompt action to rectify the record keeping issues we identified during the inspection. However, it will take time for the provider to be able to demonstrate that the actions they have taken to meet legal requirements have become embedded in practice at the service over a period of time.

The registered manager and the manager were passionate and committed to providing good care to the people they supported. They were open and transparent with people and their relatives. Staff were engaged with the service and their views sought to develop and improve the quality of care provided. The registered manager worked in partnership with other agencies where appropriate.