Nexus Support Ltd

Updated 8 January 2019

The inspection

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.

Inspection team: One inspector and an expert by experience carried out this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.  

Service and service type Nexus provides personal care and support to people in their own homes. 26 people were receiving a service at the time of the inspection. 

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours' notice of the inspection site visit, because it is small and the manager may have been out of the office supporting staff or providing care. We needed to be sure that they would be in.’

Inspection site visit activity took place on the 18/12/18 and ended on 20/12/18. We visited the office location on the 18/12/18 to see the registered manager and office staff; and to review care records and policies and procedures. We conducted phone calls on the 20/12/18.

What we did:

We reviewed information we had received about the service since the last inspection. We assessed the information that providers are required to send us annually. This gives us key information about the service, what the service does well and improvements they plan to make. We used all this information and the previous inspection report to plan our inspection.

People receiving care at the time of inspection were not fully able to share with us their experiences of the service, so we spoke with their relatives or representatives. We spoke with 8 relatives, 3 members of staff, the deputy manager and the registered manager.

We reviewed three staff files around staff recruitment and various records in relation to training and supervision of staff. We looked at audits and quality assurance procedures relating to the management of the service, which had been developed and implemented by the provider. Some of this information was received following the inspection visit. 

Updated 8 January 2019

What life is like for people using this service:

People continued to receive safe care. Staff knew how to keep people safe from harm and people told us they felt safe. There were enough staff to support people safely. People told us they were supported by consistent staff and received their medicines on time and in the right way. Staff had received training in infection control and had access to personal protective equipment. Accidents and incidents were noted and trends were monitored.

People continued to receive effective care, from a small team of staff who were, skilled and competent in meeting people’s individual needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff supported people to maintain a healthy diet, in line with their assessed needs, and to access health care if this was needed.

People received care from staff who were kind and caring. People had positive relationships with staff and were confident in the service to be able to meet their needs in a kind and compassionate way. People were supported and encouraged by staff to make decisions as to how their needs were met. Staff understood the importance of respecting people’s privacy dignity and independence.

Staff continued to support people in a responsive way. Assessments and support plans were in place which identified what was important to people and how they should be supported. The support people received was centred around them, and they were involved in any decisions made. The provider had systems in place to resolve complaints appropriately. The service needed to develop their approach toward end of life care. We have made recommendations about complaints and end of life care.

The service continued to be well managed. The registered manager was approachable and people knew them well. Spot checks and audits were completed to ensure the quality of the service was maintained. There was a strong value base to ensure that workers were caring and compassionate. People, and their family members were actively encouraged to provide feedback on the service and staff worked well as a team in an open and supportive manner. Everyone spoke positively about the service and the quality of the support being provided.

More information is in the detailed findings below.

Rating at last inspection: Good (06/04/2016)

About the service: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to adults, younger adults who may have had a learning disability or autism. At the time of the inspection 26 people were using the service. The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive, and will inspect the service again, if we receive information that indicates risk.