Background to this inspection
Updated
20 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection. It took place on 29 January 2018 and was announced. The reason it was announced was so people who would find our visit a challenge, could be informed that we would be visiting or contacting them. This was to help them prepare for our contact. The inspection was carried out by one adult social care inspector.
Inspection site visit activity started on 29 January 2018 and ended on 2 February 2018. We visited the office location on 29 January to see the manager and office staff, and to review care records and policies and procedures.
We used a range of methods to help us make our judgements. This included visiting two people in their homes and talking with one relative by phone. We spoke with two nurses, three health care assistant, two team leaders, two allocation officers and the registered manager. We pathway tracked three people, (reading care plans, and other records kept about them), and reviewed other records about how the service was managed.
Before the inspection we reviewed information we held about the service and notifications of incidents we had received. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern. We also reviewed the Provider Information Record (PIR). The PIR provides key information about the service, what the service does well and the improvements the provider plan to make.
Updated
20 March 2018
Newcross Healthcare Solutions Limited (Truro) is a domiciliary care service which provides complex care and support to people of all ages in their own homes. The service provides help with people's complex care and personal care needs in Cornwall. The packages of care that Newcross provide ranged from a minimum of four hours a day up to 24 hour care dependant on the person’s care needs.
Not everyone using Newcross receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection 26 people were receiving support with personal care needs.
There was a registered manager in post who was responsible for the day-to-day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The registered manager had been appointed ten weeks prior to this inspection and was therefore new to the Cornwall branch. The registered manager also oversaw two other locations and divided their time between the three Newcross offices. People, relatives and staff felt the registered manager spent sufficient time at the office and was available at all times.
We carried out this announced inspection on 29 and 31 January and 2 February 2018. At the last inspection, in November 2015, the service was rated Good. At this inspection we found the service remained Good.
People we spoke with told us they felt safe using the service and said they trusted the staff that supported them. People and their relatives were extremely satisfied with the quality of the service they received and the caring approach from staff. People said about the service, “Carers are excellent, I would be lost without them”, "They want to do their best, they want to be outstanding” and ”They (staff) genuinely care.”
Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.
Staff were aware of the reporting process for any accidents or incidents that occurred and there was a system in place to record incidents. Where accidents, incidents or near misses had occurred these had been reported to the service’s managers and documented in the service’s accident book.
People were supported by dedicated teams who were employed to work specifically with each person using the service. Staff knew people well and had received training specific to their needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. People told us they were never supported by someone they did not know.
Staff were recruited in a safe way and available in sufficient numbers to meet people’s needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.
The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service’s visit schedules were well organised and there were a sufficient number of trained staff available to provide people’s care visits in accordance with their preferences. Newcross operated an on call system outside of office hours. Relatives and staff told us managers would respond promptly to any queries they might have.
There were processes in place to protect people and the security of their home when they received personal care, for example having access to personal protective equipment and carrying identification. People and their relatives had a copy of the staff rota so they knew who would be delivering their care and aware of who was due to call upon them.
Staff were respectful of the fact they were working in people’s homes. The service offered flexible support to people and were able to adapt in order to meet people’s needs and support them as they wanted.
People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act.
Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them in any way. People’s legal rights were understood and upheld.
Everyone told us staff ensured their dignity and privacy was promoted.
People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person’s individual needs and wishes. The service’s risk assessment procedures were designed to enable people to take risks while providing appropriate protection.
Newcross management structure provided clear leadership to the staff team and were valued by people, staff and relatives. There was a shared team culture, the focus of which was how they could do things better for people.
People and their relatives were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.