Newcross Healthcare Solutions Limited (Plymouth) was rated Requires Improvement overall following an April–May 2018 inspection, with a breach of Regulation 17 found across safe, responsive and well-led domains due to incomplete risk assessments, care plans that did not reflect people's preferences, and insufficient governance oversight of records. Strengths included compassionate, well-trained and safely recruited staff, positive feedback from people and professionals, and effective use of complaints and incidents for learning.
Concerns (6)
criticalRecord keeping: “The provider had not ensured accurate and contemporaneous records were held about each person's needs in order to reduce risks to them. This is a breach of Regulation 17”
criticalCare planning: “one person was fed through their stomach but their risk assessment did not detail that they sometimes chose to eat solid food which would increase their risk of choking.”
criticalGovernance: “there were no records showing how the provider monitored records relating to people's care, such as care plans and risk assessments, to ensure they met the standards required.”
moderateCare planning: “care plans did not always reflect people's preferences for how their care and support was provided, the routines they liked to follow or their wishes and aspirations.”
moderateGovernance: “The registered manager did not have a clear plan in place that showed how they were monitoring all aspects of the service.”
moderatePerson-centred care: “people's hopes, dreams and aspirations, and what steps staff needed to take to support people with these, were not always recorded.”
Strengths
· Staff were recruited safely and matched carefully to people according to skills, knowledge and experience.
· Staff training was designed around individual people's needs, including training delivered by healthcare professionals.
· People and relatives spoke highly of staff; staff demonstrated compassion and treated people as individuals.
· The computer system alerted office staff if a scheduled visit had not been attended, helping prevent missed visits.
· Complaints and incidents were monitored and used to drive improvement across the organisation.
Quality-Statement breakdown (10)
safe: Risk assessments did not always reflect all risks or contain sufficient guidance for staff on managing them.Requires improvement
safe: Staff understood safeguarding responsibilities and were recruited safely.Good
effective: Staff training was individualised and competency-assessed; staff supported people effectively including health monitoring.Good
effective: Staff understood and applied MCA principles; consent was sought before providing care.Good
caring: Staff were compassionate, respected dignity and privacy, and supported people's independence and wellbeing.Good
caring: People and relatives were encouraged to express views and make decisions about their care.Good
responsive: Care plans did not always detail people's preferences, routines or aspirations consistently.Requires improvement
responsive: People were supported to be socially and cognitively active and information was provided in accessible formats.Good
well-led: No clear plan existed to regularly monitor all aspects of the service including care records and risk assessments.Requires improvement
well-led: Feedback, complaints and incidents were monitored and used to drive organisational improvement.Good
Newcross Healthcare Solutions Plymouth improved from Requires Improvement to Good across all five key questions, having resolved a previous breach of Regulation 17 around record-keeping and risk documentation. The service demonstrated strong clinical oversight, specialist staff training, person-centred care planning, and effective partnership working for people with complex health needs.
Strengths
· Staff were competency tested in medicines and specialist care procedures before working independently, with ongoing revalidation by clinical leads.
· Specialist and detailed staff training provided, including for complex needs such as tracheostomy, PEG care, ventilation, and acquired brain injuries.
· Strong continuity of care: people were supported by regular staff, with additional trained staff available to cover absence without interrupting care packages.
· Person-centred care plans were accurate and co-produced with people, who were actively involved in planning and reviewing their care.
· Robust quality assurance system with audits, delegated weekly actions, and reflective registered manager who demonstrated learning from incidents.
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood