Nurse Plus UK - Truro

Nurseplus did not provide short visits. The packages of care provided at the time of this inspection included visits of several hours at a time, and one live-in care package.

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.

People were protected from potential abuse and avoidable harm by staff that had regular safeguarding training and knew about the different types of abuse.

Risks were identified, assessed and recorded. Care plans were completed for each person and contained details of the person's needs and preferences. These assessments included any risks from the environment and included any emergency action needed in the event of a water leak or fire in the person's home. Risks to staff working alone late at night had been identified.

Staff did not just focus on meeting people's assessed personal care needs. We were told repeatedly how staff went above and beyond their roles as carers to ensure people were well supported in all areas of their lives. Staff took pets to the vet, ordered heating oil when necessary and helped arrange contractors to do necessary work in people's home.

People received outstandingly consistent support from their carers from Nurseplus, which continued throughout the COVID-19 pandemic. Many staff had been supporting the same person for many years.

Medicines were managed safely to ensure people received them safely and in accordance with their health needs and the prescriber's instructions.

There were sufficient staff to support people. Recruitment procedures were robust. Regular auditing took place of all records at the service by the area manager.

People's care and support needs were assessed before they started using the service. People were matched with specific care staff and people and their families were involved in the recruitment of their staff.

People received support to maintain good health and were supported to maintain a balanced diet where this was part of their plan of care. The service supported some people, who lived alone, with their food shopping and meal preparation. There was a strong emphasis on the importance of eating and drinking well. Positive staff relationships were used to encourage those who were reluctant or had difficulty in eating and drinking.

The service had innovative and creative ways of training and developing staff that helps them put their learning into practice delivering outstanding care that met people's individual needs.

The staff recognised that there was some wasted food each week which was surplus to the person's needs. So, the service designed a training package for all staff, to help reduce food wastage and focus on producing a wider variety of healthy well-balanced meals, saving people money and increasing their choice of meals.

People were supported and received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs. Nurseplus had a robust system to monitor all staff training requirements and offered refresher training to keep them up to date with best practice. Training had been provided face to face in the training suite and competency assessments were regularly carried out throughout the COVID-19 pandemic.

The registered manager had continued to support all staff in people's homes throughout the COVID-19 pandemic, by visiting and talking with staff and people to ensure the best service was being provided. The registered manager had recognised the staff were isolated during their shifts in people's homes and was keen to ensure they saw them face to face regularly to provide support.

Staff told us, "Working throughout the pandemic saved me, it was a life-line. My client needed me to be there and I needed to be there. It was a strange time but we got such fantastic support from Nurseplus management. We all needed each other. I cannot fault them in any way. They are amazing" and "The management come out regularly and do spot checks on us, and we have very regular medication training updates. It is surprising how quickly each update comes around again!"

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.

Staff understood the importance of respecting people's diverse needs and promoting independence. Mental capacity assessments had taken place where necessary.

The registered manager was very keen to ensure the service was as responsive to the needs of the people they supported as they could possibly be. The service was outstandingly flexible in supporting people's needs. Staff told us, "We can be super flexible and if a person wants to change a time or a day of their visit, it is done."

People told us, "Outstanding, all parts of the organisation are outstanding as far as I can see. All phone calls, and emails are replied to promptly and the finance department is very efficient at sorting stuff out," "It appears to be outstanding, even when they had COVID-19 they were able to provide the same service" and "The office always get back, I've never had to chase them. Their communication is very, very good."

Relatives comments included "The staff at the office are outstanding. If I email a mediation change, it's changed immediately. The communication is also outstanding" and "I usually ring if I want extra cover or to

change. If the person who deals with it is not there, they call back quite soon. They accommodate me whenever they can. They really do try."

There were robust auditing or monitoring processes in place. The service had implemented effective quality assurance systems to monitor the quality and safety of the care provided. Spot checks were carried out to monitor staff performance. The service was regularly audited by the quality assurance advisor and was scoring 'green' at the time of this inspection, which meant there were no concerns.

The registered manager recognised a member of the care staff each month for an award. This was seen as motivational and recognition of staff showing commitment to good care. Staff received chocolates, flowers and a certificate to evidence their good work. Annually a member of staff was recognised to going above and beyond the call of duty and similarly rewarded.

Everyone we spoke with about Nurseplus UK told us they thought they provided an outstandingly consistent effective service. We were told staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected.

Comments included, "I only have one person and she comes at the same time, stays the right amount of time. I've never had anyone else; it's always been the same one I'm pleased to say," 'It's been really consistent since we started," "They work really hard to provide a regular team" and 'Mum's care is outstanding, and her clothes are all clean and the flat is clean, it's outstanding" and "The current carer is outstanding and very experienced; she has picked up on lots of bits and pieces and acted upon them."

The service worked in partnership with other organisations to make sure they were following current practice and providing a high quality service. The service had sustained their outstanding practice since the last inspection as their previous location.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk