Cambridge Nursing Agency is registered to provide personal care to people living in their own homes. At the time of the inspection there was one person using the service. There was only one member of staff employed to provide care for the one person using the service.

This announced inspection took place on 2 March 2016.

At the time of the inspection there was a registered manager in place. 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.

People felt safe and staff knew what actions to take if they thought that anyone had been harmed in any way. There were procedures in place which were being followed by staff to ensure that people received their medication as prescribed. Staff were aware of the action to take to reduce the risk of people having accidents.

There were enough staff available to meet people’s needs. Staff received the support and training they needed to carry out their roles effectively.

Staff were kind and compassionate when working with people. They knew people well and were aware of their life history, preferences, and their likes and dislikes. People’s privacy and dignity were upheld.

Staff monitored people’s health and welfare needs and acted on issues identified

People were provided with a choice of food and drink that they enjoyed.

There was a complaints procedure in place so that people could raise any concerns with the staff or the registered manager.

The registered manager obtained the views from people that used the service, their relatives and staff about the quality of the service.

The registered manager had failed to provide the commission with information requested prior to the inspection.

Cambridge Nursing Agency offered a service to three people within their own homes. During our visit we met with one member of staff. Following our visit we spoke with one person who used the service and the relatives of the other two people. We also spoke with the staff and the registered manager who were not present during our visit.

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. They told us they felt comfortable in the presence of staff and able to talk to them if they had concerns. They said the manager was approachable, and that, although they were comfortable to talk to staff directly, they were confident they could talk to the manager if necessary.

We found that the provider and staff had an understanding of their responsibility to protect people from abuse and were aware of local authority reporting procedures.

We found that all the required checks had been completed before staff started work and that staff received appropriate training to meet people’s needs safely.

Is the service effective?

We found from records and from talking with people, their relatives, and staff, that the service placed an emphasis on personalised care. People were supported by regular staff who knew their needs and preferences well. One staff member spoke about how they planned support to maximise people’s opportunities to stay in control and do as much for themselves as possible. This meant that people were offered support in a way that upheld their dignity and promoted their independence.

Is the service caring?

People were cared for by kind, respectful staff. People and their relatives told us told us that they had good relationships with the staff who cared for them. One relative said, "(Staff name) is amazing, fantastic. I have nothing bad to say at all."

Is the service responsive?

We found that the service was flexible in response to people’s needs and preferences. One relative told us, “Care is offered in the way my relative chooses and at their pace.” People told us they felt able to talk to staff and to the manager about their wishes. We saw from records that care plans were reviewed regularly and in response to incidents or changes in people’s needs.

Is the service well led?

Cambridge Nursing Agency is a very small service. The manager told us that they speak with staff and people who used the service or their relatives on a daily basis. This was confirmed by staff and relatives who all felt that communication was good between them and the manager. All the people and staff that we spoke with told us they felt confident that any concerns would be listened to and acted upon. The service had a complaints procedure, a copy of which was included in the service user’s guide. People and their relatives were aware of the procedure but all stated that they had no cause for complaint to date.

Cambridge Nursing Agency is a very small domiciliary care agency, which currently supports four people in the community. As part of our inspection on 7 June 2013 we visited two people in their own homes and spoke to three members of staff, which included the manager. We saw that there were people who needed two care staff to assist with moving and handling using a hoist and two staff were always provided. One person had a live in carer and a Cambridge Nursing Agency care staff member provided the extra care needed for the person to be hoisted and their personal care to be given safely.

The family member of one person said, "They do a good job". Another person told us, "They are excellent. I have had one or two that were not good (from a different agency). I recently went in my wheelchair to town and that was marvellous. The carers are going to take me again next week".

There were only three care staff and the manager who provided care and this meant people had regular carers that they knew well. One person said, "Four of them interchange and the care is very good." People said the carers were, "...usually on time and were only late if the traffic was a problem".

As the purpose of this inspection was to assess improvements made in relation to shortfalls identified during our previous review of complaince undertaken in September 2012, we did not request information directly from people using the service on this occasion.

During our inspection on 17 September we spoke with the provider, care staff and family members of four people who used the service. All the family members we spoke with said they were impressed with the agency. One relative said the agency was, "Excellent, more than delighted", and "Outstanding, absolutely fab". People talked about the level of flexibility and professionalism in the agency and told us they would recommend it to others.

There were some issues in relation to care plans and medication administration records, but due to the small numbers of people provided with support meant that care staff, people who use the service and their family members were able to discuss any care or health issues directly.