Background to this inspection
Updated
4 March 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 team consisted of two inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Both our Expert’s by Experience had direct experience of caring for a family member at home.
Service and service type
The service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service 24 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 12 January 2021 and ended on 18 January 2021. We visited the office location on 18 January 2021.
What we did before inspection
We reviewed information we had received about the service since the last inspection although 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 sought feedback from the local authority and professionals who work with the service.
During the inspection-
We spoke with 14 people who used the service and four relatives about their experience of the care provided.
We spoke with eleven members of staff including the provider, registered manager, and a senior manager.
We reviewed a range of records. This included four care records and multiple medication records. We looked at two 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.
Updated
4 March 2021
About the service
Nobilis is a care at home service providing personal care and support. At the time of the inspection around 100 people were receiving support with personal care
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
The provider’s systems that were used to robustly identify shortfalls in the service had failed to act on and learn from concerns over the last 12 months. This meant that improvements required were not acted on in a timely way. Improvements were also needed to the complaints processes.
Staff were able to access appropriate personal protective equipment (PPE) to help prevent the spread of infection.
Staff were trained and competent in their role. Staff received supervision and appraisals to monitor their performance and identify any learning needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.
People and their relatives were overall very positive about the care and support and kindness of the staff who supported them.
Rating at last inspection
This service was registered with us on 8 July 2019 and this is their first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about medicines, infection control and staffing. A decision was made for us to inspect and examine those risks and to provide a rating for the service.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified that systems and processes were not robust enough to demonstrate quality and safety were effectively managed.
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.