N-Able Care

Updated 8 July 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 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.

Notice of inspection

We initially gave the service 72 hours’ notice of the inspection. This was because we needed to be sure the provider would be in the office to support the inspection. Due to the providers availability, the inspection started a week after notice of the inspection was given.

Inspection activity started on 2 June 2023 and ended on 28 June 2023. We visited the location’s office on 9 June 2023.

What we did before the inspection

We reviewed information we had received about the service.

During the inspection

We visited the location's office on 9 June 2023. We reviewed a range of records. This included policies and procedures, 2 staff files, 1 person’s care records, medication records, training data and quality assurance records. We visited the person who used the service and sought feedback about their experience of the care provided.

Following the site visit, we sought and received feedback from 2 staff.

We also used the information the provider sent us in the provider information return (PIR). This was submitted prior to the inspection, but not available until during the inspection. The PIR is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

Updated 8 July 2023

About the service

N-Able Care is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection they were providing a personal care service to 1 person. This was provided by the provider and 3 self-employed carers, with the provider overseeing the care being delivered.

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

Right Support

The person had risk assessments and a care plan in place, however, these did not include sufficient information to guide staff to provide care and support. Although a small team of staff supported the person who knew the person well, they did not always have detailed guidance to ensure people received safe care at all times. We did not find this had a negative impact on the care the person received as the person receiving support was able to say what support they required, but we have identified these as areas of practice that need to improve.

Staff understood how to protect people from poor care and abuse. Some staff had not received training in safeguarding vulnerable adults.

The person was supported to have maximum choice and control of their life 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. The person told us staff supported them to be independent and to have control over their own life.

The person was supported to maintain their health and wellbeing. Staff enabled the person to access specialist health care support within the community.

Right Care

Recruitment procedures were not always safe, and improvements were needed to ensure staff received training and appropriate assessments of their competence to fulfil their role. The person told us they were involved in recruitment of their own staff.

Infection control procedures were not always robust, and staff mostly followed systems and processes to safely administer medicines. However, improvements were needed to ensure medicines records were accurate, and staff received appropriate training and competency assessments.

The person was well treated and supported. Staff knew the person and their needs and preferences well and the person received consistent care. Staff respected and promoted the person to be as independent as possible. The person confirmed to us they felt involved in their care and were aware of how to raise any concerns they may have.

The person could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The person told us their communication needs were met with written information provided to them in a format that supported their understanding.

Right Culture

Improvements were needed to make sure there were effective systems to monitor the quality of the service and plan improvements. The provider was open and transparent throughout our inspection. They acted on queries and our feedback throughout the inspection.

The person was complimentary about the care and support they received and spoke positively about the service. We found no evidence that the person was harmed by the shortfalls we found, but these shortfalls put them at increased risk. We discussed these concerns with the provider who was responsive to feedback and started making changes during the inspection to improve support for the person.

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

Rating at last inspection

This service was registered with us on 19 May 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to staff recruitment, staff training and management of the service at this inspection.

We have also made recommendations in relation to medicines management and infection control.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.