Newcross Healthcare Solution Limited (Chichester) is a domicillary care agency (home care). It provides personal and nursing care to children and adults in Chichester and the surrounding areas. This inspection took place on 25, 26, 31 January 2018. 72 hours’ notice was given as the service is small and we needed to be sure the registered manager would be available when we visited the agency offices. This time also enabled the registered manager to arrange home visitswhich allowed us to hear about people’s experiences of the service.

There was a registered manager in post. 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.

This service is a domiciliary care agency providing complex care packages. It provides personal and nursing care to people living in their own houses. It provides a service to older adults, younger adults and children. Some people may be living with dementia, have physical and learning disabilities and some people and children have complex care needs.

People and their relatives told us staff were caring and kind. Staff demonstrated kindness and compassion for people through their conversations and interactions. People’s privacy and dignity was promoted. People, where possible were actively involved in making choices and decisions about how they wanted to live their lives. People were protected from abuse because staff understood what action to take if they were concerned someone was being abused or mistreated.

People received care which was responsive to their needs. People, their relatives and professionals were encouraged to be part of the care planning process and to attend or contribute to care reviews. This helped to ensure the care being provided met people’s individual needs and preferences. Support plans were personalised and guided staff to help people in the way they liked.

Risks associated with people’s care and living environment were effectively managed to ensure their independence was promoted. People were supported by consistent staff to help meet their needs. People’s independence was encouraged and staff helped people feel valued by engaging them in the personal, small things which mattered to them.

The registered manager and provider wanted to ensure the right staff were employed, so recruitment practices were safe and ensured that checks had been undertaken.

People received care from staff who had undertaken advanced training to be able to meet their unique needs to maintain their health and well-being at home. Staff confirmed training enhanced their skills and confidence. For families the high standard of training meant their children were able to be at home rather than in high dependency hospital beds.

People’s human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA). People, or families where appropriate were involved in all aspects of care delivery.

People’s nutritional needs were met because staff followed people’s support plans to make sure people were eating and drinking enough and potential risks were known. Additional training such as PEG training and NG tube feeding (food given via a tube passed through the stomach or nose) enabled people to receive their nutrition by skilled staff where their health needs required this. People were supported to access health care professionals to maintain their health and wellbeing. Medicines were administered safely by trained and competent staff.

Staff supported people and their families at the end of their lives with tenderness and compassion ensuring people’s last wishes were known, shared and delivered by the Newcross team.

Policies and procedures across the service ensur