Nestora Home Care

Updated 2 April 2020

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

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 05 February 2020 and ended on 14 February 2020. We visited the office location on 10 and 11 February 2020.

What we did before inspection

We reviewed 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. We used the information the provider sent us in the provider information return. 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 used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and two relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, care co-ordinators, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

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

After the inspection

We continued to speak to people and their relatives on the phone about the experience of the care provided. We spoke with four people and three relatives.

Updated 2 April 2020

About the service

My Homecare Huddersfield is a domiciliary care agency which provides support to people in their own homes. It provides a service to younger and older adults, people with physical disabilities, sensory impairments, learning disabilities, dementia or mental health conditions. At the time of inspection 63 people were using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Systems were either not in place or robust enough to demonstrate medicines were effectively managed. Improvement was required to medication administration records (MARs). The provider’s medicine policy was not always adhered to by staff.

The provider had not operated robust systems and processes to assess, monitor and improve the quality and safety of the service. They had not maintained accurate and complete records. The provider did not sufficiently address all the concerns raised from the last inspection. Audit systems were not robust and governance systems failed to identify the issues we found during the inspection.

The provider had not met all of their statutory requirements. The provider had failed to notify the CQC of a change of the provider’s registered address and a change to their statement of purpose.

People were protected from the risks of abuse and harm and people said they trusted staff to keep them safe. Staff had received training in safeguarding adults and understood how to recognise signs of abuse. Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff had the necessary safety checks in place before starting work and completed a full induction.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We have made a recommendation about the provider considering best practise and training for completing mental capacity assessments

People told us staff were kind, courteous and sensitive. People’s comments included, “They [staff] are caring” and “They [staff] are all nice and cheer me up.”

People told us the care workers arrived on time to deliver their care, and if they were delayed people were informed of this. We received mixed feedback about the continuity of care workers. Some people told us they received regular care workers and other people felt there was no continuity.

Staff had received end of life training and the service worked closely with healthcare professionals to deliver end of life care should people wish to remain at home. We have made a recommendation about the provider reviewing their processes to give people the option to make their end of life wishes known.

Staff felt valued and supported by the management team. They were clear about the culture of the organisation and what was expected from them. Staff told us, “Management are really good. Really supportive and helpful.”

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 20 February 2019) and there was a breach of a regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.