Archived: Niche Care Calderdale

Updated 24 June 2022

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 one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was on maternity leave. In their absence, the service was being overseen by the registered manager of Niche Care Kirklees.

Notice of inspection

We initially gave 24 hours’ notice of the inspection. This was to ensure the manager or a representative of the provider was available to support the inspection and so we had prior information to promote safety due to the COVID-19 pandemic. The notice period also allowed the provider time to start asking people using the service and their relatives, if they would be prepared to speak to us about their experiences. Due to unforeseen circumstances, the inspection had to be delayed by a further 48 hours. Inspection activity started on 26 April 2022 and finished on 17 May 2022, by which time we had received and reviewed additional information sent following the visit. We conducted the office visit on 29 April 2022.

What we did before the inspection

We reviewed information we had received about the service since it was registered. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We used the information the provider sent us in the provider information return (PIR). This 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. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service and two relatives about their experiences of the care provided. We captured the views of two other relatives via an emailed questionnaire. We spoke with Niche Care’s director of the Yorkshire region and three staff members. Following the office visit we also spoke with the current manager of the service via telephone, as they were on annual leave when we visited the service.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment, training and support. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at surveys, training information, policies and procedures, staff rotas and call monitoring information.

Updated 24 June 2022

About the service

Niche Care Calderdale is a domiciliary care service based in Halifax. At the time of inspection, the service was being run from the office of Niche Care Kirklees based in Huddersfield. This was due to the small number of people being supported by Niche Care Calderdale and because the registered manager of the Kirklees branch was managing both services, whilst the registered manager of the Calderdale branch was on maternity leave. At the time of inspection, Niche Care Calderdale were supporting six people, although one was in hospital and had been for some time.

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

We found improvements were required with ensuring care was provided in line with care plans, management of complaints, the timing and duration of care visits, and timeliness with which issues were addressed.

Care plans were detailed and clearly explained how people wanted to be cared for or supported. However, people and relatives provided mixed views about the actual provision of care, with some stating carers did not always follow the care plan, which they felt was linked to the inconsistency of visit times and carers being rushed.

People told us they knew how to complain and two relatives confirmed complaints had been reported to the service via phone calls. We found no record of these concerns within the service’s complaints file. The manager told us this was because these issues had not been escalated to management by the person they had been reported to.

The times of people’s care visit were inconsistent and staff did not always remain for the full duration of the call. People told us this was one of the main concerns with the service.

We have made a recommendation about the provider ensuring visits are scheduled in line with agreed times as stated on people’s care plans.

A range of audits and governance processes were in place to monitor the quality and effectiveness of care delivery. Actions were generated from audits and added to the services improvement plan. Although a number of the issues reported to us by people and/or relatives had been identified through the audit process, actions and improvements had not been made timely.

We have made a recommendation about the audit and action plan process.

People told us they received safe care, although some staff were ‘better’ than others. Staff had received training in safeguarding and knew how to report any concerns. People who received assistance to take their medicines, had no concerns with the support provided. However, one relative felt staff needed to be more observant when administering medicines. People confirmed staff wore PPE and staff told us specific COVID-19 training had been provided

Staff told us they received enough training and supervision to carry out their roles. 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.

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 3 August 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration in order to provide an initial rating for the service.

We have found evidence that the provider needs to make improvements. Please see the safe section of the full report.

You can see what action we have asked the provider to take at the end of the full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.