KMX Nursing Agency

Updated 8 June 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 was carried out by one 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.

The service had two managers 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. 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 29 April 2021 and ended on 7 May 2021. We visited the office location on 29 April 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and two relatives about their experience of the care provided. We spoke with four members of staff including the registered managers and care workers.

We reviewed a range of records. This included four people’s care records including medicine records. A variety of records relating to the management of the service, including incident reports and policies and procedures were reviewed. We looked at two staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a health professional who has regular contact with people using the service.

Updated 8 June 2021

About the service

KMX Nursing Agency is a domiciliary care agency providing personal care to adults living with families or in their own homes in the community. 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. At the time of our inspection the service was supporting five people living with frailty and other health related conditions and younger people living with learning disability and/or Autistic spectrum conditions.

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

People were supported to have maximum choice and control of their lives 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.

People’s care plans and risk assessments were written in a person-centred way; however, the provider was using two different systems to record this information. Improvement was needed to streamline this to avoid the potential for confusion.

The quality assurance system was not formalised and improvements were needed in how the provider assessed, monitored and used their systems to drive improvements.

Staff were recruited safely and received training and supervision to support them in their role and identified any learning needs and opportunities for professional development.

Staff supported people to have enough to eat and drink and to make choices about what they ate and drank. People received appropriate healthcare support as and when needed and staff knew what to do to summon assistance.

People and their relatives told us they were given every opportunity to be valued and equal partners in decisions around their care and support. This was reflected in the good quality care and support people received, from a committed and caring group of staff. One relative said, “they have attention to detail, nothing is too much trouble, they go above and beyond.”

People, relatives and staff told us that they were encouraged to give feedback about the care delivered and communication was good with the staff and registered managers.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

People were supported in their own family home. Staff had the training, knowledge and skills to understand people’s specific needs. Care plans were person centred and detailed with an emphasis on how people’s communication was to be supported.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 September 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements.

Enforcement

Since the last inspection we recognised that the provider had failed to comply with the display ratings requirement. This was a breach of Regulation 20A of the Health and Social Care Act 2008. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for KMX Nursing Agency on our website at www.cqc.org.uk.

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 to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.