B Pro Nursing Agency

Updated 8 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to meet with us. Inspection activity started on 3 May 2021 and ended on 12 May 2021. We visited the office location on 06 May 2021.

What we did before the inspection

We reviewed all the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with one person who used the service and five family members about their experience of the care provided. We spoke with six members of staff including the registered manager, care coordinator, and care staff. We had email feedback from a further three staff and talked to one professional. We had further emails from four professionals about their view of the service.

We reviewed a range of records. This included three people’s care records and medicine records. We looked at three staff files in relation to recruitment and staffing. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. Further information was sent to us as requested. This included training data and quality assurance records.

Updated 8 June 2021

About the service

B Pro Nursing Agency is a domiciliary care service which provides personal care to older people living in their own homes. At the time of the inspection the service was supporting 19 people.

People’s experience of using this service and what we found

The previous inspection in November/December 2019 found people's medicines were not always managed safely, there was no system for monitoring missed and late calls, personal protective equipment (PPE) was not always available and staff were not sufficiently trained for the role, especially in relation to end of life care. Staff reported a negative culture in the service and there was a lack of governance and oversight.

At this inspection we found improvements had been made to ensure people received their medicines safely, staff were trained to deliver high quality care, the culture of the service was positive and management systems were in place to monitor the quality of the service

People and their family members told us they received care and support which was reliable and consistent from caring staff. Rotas were organised in a way which meant people saw the same team of staff so that relationships were developed and maintained.

Staff had a good understanding of safeguarding processes to keep people safe and how to report any concerns. Staff understood and were aware of their responsibilities to raise concerns and report all incidents. People told us they received their medicines when they needed them. We were assured the service met good infection prevention and control guidelines and PPE was readily available. There were enough staff to provide care and support to people and staff had been suitably recruited to their role.

Staff were aware of people’s needs and supported them to manage risks to their safety whilst supporting them to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

People’s needs had been assessed before using the service. Care plans contained comprehensive information about people’s needs and ways in which they should be met. This included their routines, preferences and wishes. People had received end of life care from staff who were trained, sensitive and compassionate.

Staff confirmed they had received training that gave them the knowledge and skills to carry out their roles. Spot checks were carried out to monitor staff practice and ensure they were working safely. People had good support with their meals. People were supported to access healthcare where needed. Staff worked well with other professionals to ensure people’s healthcare needs were met

Staff treated people with dignity, respect and kindness. Staff had a good understanding of people's individual lifestyles and culture and respected people’s right to privacy, confidentiality and promoted their independence. Staff recorded information about people in a respectful way.

Systems had improved to assess, manage and monitor the oversight and quality of the service. Complaints were investigated and responded to. Where things had gone wrong, the registered manager and care coordinator was open and transparent with people, and their relatives and used their feedback to improve the service.

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

Rating at last inspection and update: The last rating for this service was requires improvement (published 16 March 2019) and where we identified breaches of the regulations and made recommendations for the service to improve. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvement had been made and the provider was no longer in breach of the regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.