Newcross Healthcare Solutions Limited is a domiciliary care agency. It provides care and support services to people living in their own homes in the community. Not everyone using the agency received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of the inspection, the agency was providing the regulated activity of personal care to nine adults and three children. The children and most of the adults had complex healthcare needs. Our inspection was based on the care and support provided to these 12 people, each of whom received a variety of care hours from the agency depending on their level of need.

This inspection was conducted between 30 August and 3 September 2018 and was announced. We gave the provider 24 hours’ notice of our inspection as we needed to be sure key staff members would be available.

At our previous inspection, in June 2016, we rated it as good overall. At this inspection we found the service had sustained or improved the quality of the service in all key questions.

People received exceptionally personalised care from staff who were highly trained and competent. Every staff member demonstrated a shared commitment to putting people at the heart of the service and enhancing their well-being.

People, families and professionals praised the person-centred approach taken by staff and described how it had benefited people, including people with highly complex needs.

People’s care plans were comprehensive and included detailed guidance about how people should be supported using specialist medical equipment. Care records confirmed that people’s needs were met consistently.

Staff supported people in a highly caring and compassionate way and built positive relationships with people and their families. They worked tirelessly to meet people’s holistic needs, including supporting people in their own time.

Staff understood people’s communication needs and used supportive techniques to communicate with them.

Staff worked collaboratively with other healthcare providers to achieve the very best outcomes for people. They supported people effectively when they accessed or transferred between care services and went out of their way to make the transition as smooth as possible.

Staff had experience in delivering end of life care and were committed to ensuring people received a comfortable, dignified and pain-free death

Everyone we spoke with praised the high quality of leadership at Newcross. People benefited from a service where staff were happy and motivated to provide the best possible care they could for people.

There was a comprehensive quality assurance process in place and the service was proactive in identifying and implementing creative solutions to enhance the quality of service delivered.

Staff protected people’s rights and were exceptionally committed to helping people express their views and preferences. They involved people in risk taking decisions and identified innovative solutions that kept people safe with the minimum of restriction.

Staff understood their safeguarding responsibilities and knew how to identify, prevent and report abuse. This was reinforced by an open and transparent culture.

Staff promoted choice and independence, protected their privacy and involved people in decisions about their care.

There were sufficient numbers of staff available to complete all agreed support visits to people. The provider operated a values-based recruitment procedure to help ensure only suitable staff were employed.

There were appropriate systems in place to protect people from the risk of infection. Where the service supported people to take their medicines, people consistently received their medicines as prescribed.

Where staff were responsible for meeting people’s nutritional needs, they supported