Archived: ANA Nursing

Updated 12 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 provide a rating for the service under the Care Act 2014.

This inspection was carried out by one inspector and was supported by an expert 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. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to make sure they would be available for our inspection.

Before we visited the service we checked the information that we held about the service and the provider including notifications and incidents affecting the safety and well-being of people. Some of the people being cared for were elderly people who were living with dementia or had a specific medical condition and could not always communicate with us and tell us what they thought about the service. Because of this we spoke to family carers and asked for their views about the service

and how they thought their relatives were being cared for.

We spoke with thirteen people using the service, six relatives, eight care workers, the branch manager, the new care manger, internal trainer and the registered manager. We reviewed five people’s care plans, five staff files, training records and records relating to the management of the service such as audits, policies and procedures.

Updated 12 January 2017

We undertook an announced inspection on 7 December 2016 of ANA Nursing. ANA Nursing is registered to provide the regulated activity personal care and provides personal care, housework and assistance with medicines in people’s homes.

At the time of the inspection, the service was providing care and supporting 22 people. There were 15 care workers. .

There was a registered manager in post. 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.

At our last inspection on 10 September 2015, the service did not meet Regulations 9, 10, 14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found there were issues with care workers punctuality, there were instances in which people were not being treated with dignity and respect, care records were not person centred and auditing processes were not robust enough to monitor and improve the quality of the service. This meant the quality rating we awarded was requires improvement.

Following our September 2015 inspection we received an action plan from the service telling us what action they would take. At this inspection the registered manager was able to demonstrate that measures had been put in place since the last inspection to respond to the issues identified and meet regulations. People using the service and relatives also told us that they had found improvements had been made to the service they received since the last inspection.

Although there some instances of lateness, overall, people using the service and relatives told us their care workers turned up on time and they received the same care worker on a regular basis. There was consistency in the level of care they received. The service had a system in place to monitor care workers punctuality. However, people were not being informed promptly about changes with their care workers. The registered manager told us they would review this and ensure people were communicated with more effectively.

People and relatives told us that they were confident that most care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service.

Care workers had a good understanding of the importance of treating people with respect and dignity. Feedback from relatives indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and care workers were aware of potential risks to people and how to protect people from harm.

Arrangements were in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place. We looked at a sample of Medicines Administration Records (MARs) and found that all these were completed fully which indicated that people had received the medicines they were prescribed.

People received care that was responsive to their needs. People's daily routines were reflected in their care plans and the service encouraged and prompted people's independence. Care plans included information about people's preferences.

The service had a complaints procedure and there was a record of complaints received. There was a clear management structure in place with a team of care workers, office staff, care coordinator, internal trainer, care manager, the branch manager, the registered manager and the provider.

Staff were informed of changes occurring within the service through regular staff meetings. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through review meetings, telephone monitoring and satisfaction surveys. Records showed positive feedback had been provided about the service.

The service also undertook a range of checks and audits of the quality of the service and took action to improve the service as a result.