White Bird Care and Nursing Agency

The service had a registered manager and a manager who was in the process of applying to the Commission to become a second registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective and well-led to at least good. At the last inspection on 22 December 2016, we asked the provider to take action to make improvements in relation to breaches of regulations we found in relation to medicines, safeguarding, notifications and good governance, these actions have now been completed.

At this inspection, we found people were safeguarded from the risk of abuse. The registered manager and the manager understood their role and responsibilities to raise any safeguarding concerns for people. Records were maintained of medicines staff either administered to people or supported people to take. Staff underwent medicines training and had their medicines competency assessed regularly.

At this inspection, we found processes were in place to monitor the quality of the service people received and to seek people's feedback in order to identify any potential areas for improvement of the service for people. The manager had since the last inspection, updated the safeguarding policy to include the requirement to inform CQC of any safeguarding alerts made to the local authority.

Risks to people had been assessed and control measures were in place to manage any identified risks. People's risk assessments were reviewed at least annually to ensure they remained relevant.

There were sufficient numbers of suitable staff to support people and meet their needs. The provider followed safe recruitment practices for people. Processes were in place to protect people from the risk of acquiring an infection during the delivery of their care. Processes were in place to ensure any required learning could take place following an incident to ensure people's future safety.

People's needs were assessed prior to the commencement of the service. The manager kept themselves up to date with developments and policies reflected current guidance to ensure people received effective care.

Staff underwent an induction to their role. We have made a recommendation about the provider assuring themselves that this meets current guidance. Staff underwent a range of training and some staff completed further training immediately following the inspection to ensure they had the knowledge to provide people with effective care. Staff received regular supervision and support in their role.

Staff supported people to eat and drink sufficient for their needs. Staff had worked with health professionals to ensure people received effective care. Staff were able to support people to meet their health care needs where they required this assistance.

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 supported this practice.

People and relatives reported that staff were caring. People were treated by staff with kindness, respect and compassion during the provision of their care. People were supported to express their views and to be involved in decisions about their care and treatment as far as possible. Staff upheld and promoted people's privacy and independence during the provision of their care.

People received personalised care based on their needs and their care was kept under regular review. Staff confirmed they received relevant information about people upon which to base people's care. The service was responsive to changes in people's needs. People were supported to take part in activities that were relevant to them. Processes were in place to enable people to make a complaint if required.

The registered manager needs to ensure that record keeping standards consistently meet regulatory requirements. The manager took prompt action to rectify the record keeping issues we identified during the inspection. However, it will take time for the provider to be able to demonstrate that the actions they have taken to meet legal requirements have become embedded in practice at the service over a period of time.

The registered manager and the manager were passionate and committed to providing good care to the people they supported. They were open and transparent with people and their relatives. Staff were engaged with the service and their views sought to develop and improve the quality of care provided. The registered manager worked in partnership with other agencies where appropriate.

The five questions we ask about services and what we found