Nash Alliance Ltd

Updated 21 August 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 did not have a manager registered with the Care Quality Commission. The provider was in the process of recruiting a new manager during our inspection.

Notice of inspection

This inspection was announced.

We gave the service prior 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 in the office to support the inspection.

Inspection activity started on 16 July 2021 and ended on 6 August 2021. We visited the office location on 16 July 2021.

What we did before the inspection

We reviewed information we had about the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We contacted the local authority to seek their current views on the service but did not receive a response.

During the inspection

We spoke with the Nominated Individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Following our visit to the office we spoke with two people who used the service and five relatives and representatives about their experience of the care provided. We spoke with three members of care staff.

We reviewed a range of records. This included three people’s care records and medication records. We looked at one staff file 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 seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 21 August 2021

About the service

Nash Healthcare Ltd is a domiciliary care agency providing personal care in people's own homes. At the time of the inspection the service was providing care and support to eighteen people.

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

Staff training had still not been sufficiently monitored and staff records still showed a variation in staffs' completion of training.

We made a recommendation about monitoring staff training.

We found improvements to how people's care plans and risk assessments were reviewed and recorded to ensure they reflected people's needs.

Improvements had been made to how the quality of the service was monitored and improved. Quality assurance checks, observations of staff practices and feedback from people and their relatives were used to identify areas that required further development and drive improvement across the service.

Notifications of deaths of people using the service were being sent to us.

People and their relatives spoke positively about the quality of care and support they received from the service. We heard descriptions such as “Very good”, “Can’t fault them” and “No complaints at all”.

Staff understood their role to report any concerns or incidents to the nominated individual and their responsibility to protect people from abuse and harm.

Safe medicines management and infection control practices were used.

There were enough staff available to ensure people's care and support needs were met. The nominated individual worked alongside staff and monitored their care practices and skills.

People and their representatives told us they usually received telephone calls if staff were going to be significantly delayed.

Staff told us they felt well supported and received regular supervision sessions from the nominated individual.

People were supported to have enough to eat and drink as required.

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.

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 10 March 2020) and there were breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 29 May 2019. Breaches of legal requirements were found. The provider completed an action plan after the inspection to show what they would do and by when to improve Fit and proper persons employed and Good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nash Healthcare Ltd on our website at www.cqc.org.uk.

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.