Nissi Care Solutions is rated Good overall following a focused inspection of Safe and Well-led domains, with Safe downgraded to Requires Improvement due to scheduling gaps causing unpredictable visit timings, staff leaving visits early, and incorrect medicine administration record entries. Well-led remained Good, reflecting an open culture, responsive leadership, effective governance systems and strong partnership working with healthcare professionals.
Concerns (4)
moderateMissed or late visits: “staffing schedules had little or no travel time included...having no travel time allocated meant staff were either leaving a visit a few minutes early or arriving slightly late.”
moderateCommunication with families: “"The timings are quite erratic. Sometimes they'll ring [relative], sometimes they [staff] won't" and "There is no rotas so the timings are a bit up in the air."”
moderateRecord keeping: “Some staff had recorded a wrong entry on the medicines administration record when people had declined their medicine...staff had recorded the medicine was not available.”
minorMedication management: “Newer staff had been struggling with the electronic recording system so additional support was being provided to overcome this.”
Strengths
· People felt safe with staff; safeguarding training was in place and staff understood their responsibilities to report concerns.
· Medicines were managed safely with staff trained and assessed for competence in administration.
· Robust infection prevention and control systems; staff had full PPE supplies and relevant training.
· Risk assessments were in place and updated as needed, covering moving and handling, skin integrity and environmental hazards.
· Incidents and accidents were reviewed and learning shared with staff through supervisions and team meetings.
Quality-Statement breakdown (11)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
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: Engaging and involving people using the service, the public and staffGood