Network Healthcare Professionals Limited – Complex Care

Domiciliary care and palliative care was currently provided to people in the south area of Bristol. At the time of this inspection the complex care team were supporting people in Bristol and Gloucestershire.

There were two registered managers in post. One registered manager was responsible for the domiciliary and palliative care teams and the other was responsible for the complex care team. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

The inspection was announced. We gave the registered manager 24 hours' notice of the inspection. We did this to ensure key staff were available for the inspection. At the time of the inspection the service were supporting eight people with complex care needs, six people who were near the end of their life and 53 people with personal care. The service employed in total 115 staff.

The service people received was safe. There were effective safeguarding systems in place. Staff knew what to do if safeguarding concerns were suspected or witnessed or a disclosure had been made to them. Safeguarding training was part of the provider's essential training programme. Any risks to people's health and welfare were assessed and management plans put in place to reduce or eliminate that risk. There were sufficient numbers of care staff employed to meet people's needs. Each person supported by the complex care team had their own team of staff who had received person-specific training to ensure they could look after the person safely. There were safe recruitment procedures in place, pre-employment checks were robust and ensured only suitable workers were employed.

Where people were supported with their medicines this was done safely. Staff received safe administration of medicines training and their competency to support people properly was reviewed. The staff took appropriate measures to prevent and control any spread of infections.

The service people received was effective in meeting their needs. People's needs were assessed prior to a service being delivered. This was to ensure the service had the capacity to meet their specific care needs. For those people with complex care needs, a staff team was recruited and led by a care manager (qualified nurse) and team leaders. Staff in all three teams were well trained and well supported by the management

teams.

People were supported with meal preparation where this had been identified as one of their care and support needs. Care staff monitored those people where the risk of malnutrition and dehydration had been identified. People were supported to access any health care services they required.

People's capacity to make decisions for themselves regarding their care and support was assessed and kept under review. The staff were aware of the principles of the Mental Capacity Act 2005 and understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a caring service and the staff treated them with kindness. The feedback we received from people and their relatives was positive. We were told that people were treated with respect and dignity. There was an expectation that each person was delivered a service of the highest standard. People, and where appropriate, families were involved in planning the care and support they received.

The service was exceptionally responsive and provided each person with a person-centred service. Staff were allocated to work with the same people which meant they were able to get to know the person well and provide a consistent service. Those people with complex care needs were looked after by a team of staff who could pick up and respond to any changes in their health status quickly. People were supported to achieve personal goals and live as normal a life as possible. Feedback was gathered from people regarding their views and experience of the service they received. Action was taken if people had complaints or concerns. The registered manager used lessons learnt from any complaints to make changes to improve care delivery in response to people's views and opinions.

The service was well led with two registered managers who provided good leadership and management. In addition, office based staff ensured the service was delivered as agreed, the staff were well supported and people were satisfied with the service they received. The quality and safety of the service people received was assessed and monitored and any areas needing improvement were identified and addressed.

The five questions we ask about services and what we found