Newcross Healthcare Solutions - Nurse Agency Nurse Agency 2nd FloorThain House 226 - 230 Queensferry Road Edinburgh EH4 2BP

Inspected by: Jan Ferguson Type of inspection: Unannounced Inspection completed on: 27 October 2011

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Contents 1 2 3 4 5 6

Summary About the service we inspected How we inspected this service The inspection Other information Summary of grades Inspection and grading history

Page No 3 4 5 8 14 15 15

Service provided by: Newcross Healthcare Solutions Limited

Service provider number: SP2005007230

Care service number: CS2007147593

Contact details for the inspector who inspected this service: Jan Ferguson Telephone 0131 653 4100 Email [email protected]

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Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service.

We gave the service these grades Quality of Information

N/A

Quality of Care and Support 5

Very Good

Quality of Staffing 5

Very Good

Quality of Management and Leadership

N/A

What the service does well The service continues to have excellent communication systems with its service users. This enables them to participate in improving the quality of the service.

What the service could do better The service should continue to maintain its current high standards.

What the service has done since the last inspection The service has reviewed its system for ensuring the fitness of employees through the Protection of Vulnerable Groups Scheme.

Conclusion The service consults its service users regularly and appropriately about service quality and performance and acts upon their views.

Who did this inspection Jan Ferguson

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1 About the service we inspected Newcross Healthcare Solutions Nurse Agency is registered to recruit and supply Registered Nursing Staff to the National Health Service and private Care Homes. Newcross Healthcare Solutions Nurse Agency is part of a UK wide organisation known as Newcross Healthcare Solutions. The organisation has offices in Edinburgh, Hamilton, Falkirk and Perth. The headquarters of Newcross Healthcare Solutions is based in Devon, England. The agency had approximately 20 service users at the time of inspection, all of whom were registered Care Homes. There were 52 Registered Nurses employed at the time of inspection. Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS) took over the work of the Care Commission, including the registration of care services. This meant from 1 April 2011 this service continued its registration under the new body, SCSWIS. This is now known as the Care Inspectorate. The mission statement for the agency states that it "strives to provide care and support of the highest standards exceeding the expectations of its clients". Please note: Where the term "service user" is used in this report it relates to an organisation or another registered care provider that pays for the service provided by Newcross Healthcare Solutions Nurse Agency. Based on the findings of this inspection this service has been awarded the following grades: Quality of Information - N/A Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - N/A This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices.

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2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care.

What we did during the inspection This report was written following an unannounced inspection on 18 October 2011. Feedback was given on 27 October 2011 to the manager and regional operations manager of the service by the inspector Jan Ferguson who carried out the inspection. During the inspection evidence was gathered from a number of sources including: Evidence from the service's self assessment Quality assurance documentation Policies and procedures Staff training records/ continual professional development plans Staff questionnaires, response and action. Discussion with service users. Discussion with office staff and demonstration of IT facilities.

Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection

Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement.

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Inspection report continued Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org

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Inspection report continued What the service has done to meet any recommendations we made at our last inspection The following was a recommendation in the previous report: "The service should explore with Disclosure Scotland what is appropriate practice following initial recruitment checks, which would offer a level of public assurance that members off agency staff were not barred from working with people who are deemed vulnerable. In making this recommendation the National Care Standards for nurse agencies Standard 4 Management and Staffing arrangements." The disclosure process has since been changed. This recommendation has been met.

The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic

Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under.

Taking the views of people using the care service into account As described earlier in the report the service user relates to another service provider ,in this case, care homes. We spoke to five care home managers who regularly use registered nurses from the agency. They were all very positive about the agency and the service that was provided. They spoke of action taken appropriately if any issues raised and spoke of good communication with the agency.

Taking carers' views into account Not applicable.

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3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found.

Quality Theme 0: Quality of Information - NOT ASSESSED

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Inspection report continued Quality Theme 1: Quality of Care and Support Overall grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The service has excellent systems in place for ensuring that service users can participate is assessing and improving the quality of the service. We were told by service users that they can log on to the service's Information technology (IT) system and can give feedback to the service via their web site. We were given examples whereby the manager of the Agency would visit the service user to discuss any issues raised. We had evidence that the Agency's manager visited or telephoned the service users regularly and this was recorded. The provider had many ways of checking on the quality of the service that they provided, this included questionnaires to monitor effectiveness and whether the people who use the service were satisfied. The service users have a contract with the Agency which can be reviewed regularly if their needs change. In discussion with the manager and the operational manager it was evident that the service was continually looking at ways of improving the service. Areas for improvement The Provider identified that they were keen to encourage more service users or clients to use the opportunities provided to make their comments and suggestions for improving the service. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Statement 4 We are confident that within our service, all medication is managed during the service user's journey to maximise the benefits and minimise any risk. Medicines management is supported by legislation relating to medicine (where appropriate Scottish legislation) and current best practice.

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Inspection report continued Service strengths We were told that staff were administering medications in line with the Nursing and Midwifery Council (NMC) Guidelines for the Administration of Medications. The nurses were expected to have knowledge of each service users medication policy and procedure. We were told that the agency had highlighted that there had been an increase in the number of drug errors being reported to them. As a result the service had developed internal guidance for Care Home administration procedures. We found that this system was very thorough. The agency had a system for assuring that where possible the same nurse would be sent to a service user so that they could provide continuity of care. Training was discussed with staff as part of their yearly appraisal. At this time a check on the staff's professional practice was made to ensure that it was up to date. The agency also had an IT system to monitor staff's skills. This included alerting them when the nurses professional registration and mandatory training was due to expire. Reminders were communicated to the nurses via text or emails. Areas for improvement We suggested that the planned training for staff with regard to medications is progressed. We have made a recommendation about this. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. It is recommended that the planned training for staff with regards to medication is progressed. National Care Standards Nurse Agencies Standard 4 Management and Staffing Arrangements

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Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths We found that there were excellent opportunities for service users to participate in assessing and improving the quality of staffing in the service. The service users we spoke to advised that they were given the opportunity to comment on the staff by email, phone or in person.. They spoke of regular meetings with the manager. In larger establishments the manager gave other staff the opportunity to comment on staff's performance. We observed communication between the service users and the Agency and thought that the communication was open and constructive. Comments identified under Quality Theme 1 Quality Statement 1 are also relevant to this statement.

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Inspection report continued Areas for improvement The service should continue to maintain its current high standards with regard to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We received eight questionnaires from staff. They commented that they were given training opportunities. They told us about the nurse "chats" that were available on line through facebook and twitter. They said that it was a good way of communicating with each other. They commented that the agency was very professional. We saw the system for the agency to ensure that the staff were up to date with their training. At the staff's appraisal the staff are asked to bring their portfolio of training. The Agency developed a training plan. We were told that the nurses were been given special training in preparation for the administration of flu vaccinations. We saw that Adult Protection training was given as part of the induction for new staff. The Agency also had a system for highlighting when a staff member needed an update. The staff were asked to complete feedback forms when they had received training so that the provider could monitor the quality of the training given. If a staff member had not had up to date Moving and Handling training they were not able to work.This also applied to staff whose work permits had expired. Areas for improvement The service should continue to maintain its current high standards with regard to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

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Inspection report continued Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED

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4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection.

Enforcements We have taken no enforcement action against this care service since the last inspection.

Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1).

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5 Summary of grades Quality of Information - Not Assessed Quality of Care and Support - 5 - Very Good Statement 1

6 - Excellent

Statement 4

5 - Very Good

Quality of Staffing - 5 - Very Good Statement 1

6 - Excellent

Statement 3

5 - Very Good

Quality of Management and Leadership - Not Assessed

6 Inspection and grading history Date

Type

Gradings

16 Mar 2010

Announced

Information Care and support Staffing Management and Leadership

6 - Excellent 6 - Excellent 5 - Very Good 6 - Excellent

All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission.

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Inspection report continued To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. This inspection report is published by SCSWIS. You can get more copies of this report and others by downloading it from our website: www.scswis.com or by telephoning 0845 600 9527.

Translations and alternative formats This inspection report is available in other languages and formats on request.

Telephone: 0845 600 9527 Email: [email protected] Web: www.scswis.com

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