Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Trinity Nursing Services Ltd Unit 3 TRW Automotive Works Resolven SA11 4HN Type of Inspection Baseline Date of inspection 11/12/2013 Date of publication 08/01/2014 You may reproduce this Report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: cssiw@wales.gsi.gov.uk www.cssiw.org.uk
Summary About the service Trinity Nursing Services Ltd is situated in large well appointed offices on a previous automotive works site in the village of Resolven in the Neath Valley. The registered provider of Trinity Nursing Services is Trinity Nursing Services Limited. The Responsible Individual is Mrs Nadia Billen, who is also the registered manager. The agency mainly supplies nurses and health care support workers to care homes. This was an unannounced planned inspection that looked at two quality themes, the quality of staffing and the quality of leadership and management. In the absence of Mrs Billen, who was not there on the day of the visit, we (CSSIW) spoke with a director of the company. What type of inspection was carried out? The inspection was planned, unannounced and looked at the quality of the staffing and the quality of the leadership and management. The other two themes, the quality of life and the quality of the environment are not relevant to a nurses agency and would not be applicable to this inspection. We carried out the inspection by: Visiting the offices of the agency Speaking with one of the directors of the service Examining the records of two (2) qualified nurses Speaking with people who had used the service, in this instance, Registered Managers of three (3) care homes who regularly use the agency What does the service do well? This is not applicable to this inspection What has improved since the last inspection? Staff training in mandatory and specialised topics was evidenced in all the records viewed What needs to be done to improve the service? We did not issue any non-compliance notices on this occasion and did not find any areas of poor practice. 3
Quality of life CSSIW did not consider it necessary to look at the quality of life as this is not an area identified for the inspection of a Nurses Agency. 4
Quality of staffing People could feel confident that the staff supplied by the agency were robustly and properly recruited. We saw evidence of completed application forms that included a full personal and work history and references including those from the most recent employer. Professional qualifications were checked using the Nursing and Midwifery Council (NMC) on-line service and annual re-registration checked using the same service. Checks for criminal records were carried out using the appropriate service (now the Disclosure and Barring Service (DBS). Staff records examined were ordered, indexed and up to date. Each one had a recent photograph and there was evidence of induction, terms and conditions of employment, and that a staff handbook had been issued. We spoke with the Registered Managers of three (3) care homes, all of whom indicated a high level of satisfaction with the quality of the staff supplied to their respective services. All were complimentary regarding the agency and indicated that efforts were made by the agency to supply the same nurse if possible to their services in order to maintain continuity. All of the Registered Managers indicated that the agency office staff showed sensitivity and understanding if one of the agency nurses or care workers was found to be unsuitable for their particular speciality and would not place that worker in their home. We did not speak to any staff members on this occasion but this may be a focus for future inspections. 5
Quality of leadership and management Overall, the service appeared to be well managed although we did not meet the Registered Manager on this occasion. We spoke with one of the directors of the company who was present on the day and who was clearly knowledgeable in most aspects of the agency. People can be confident that information is securely and properly kept in locked filing cabinets in locked premises. We saw evidence of this in an office which was remote from the reception area so that access to information by unauthorised persons would be difficult. Certificates of insurance and registration were prominently displayed in the main reception area. We found systems in place to ensure that the service operated smoothly. A list was kept of availability of staff which was frequently and regularly updated. When a request for the service was made, the list was checked, workers notified by text message asking for their availability and asking them to contact the office, and the service making the request contacted within a short time. This was confirmed by the Registered Managers spoken with, who also indicated that on the very few occasions when the agency could not supply anyone, they were notified immediately. We were informed by all Registered Managers spoken with that they found all members of the agency approachable, one stating that Trinity go the extra mile. 6
Quality of environment CSSIW did not consider it necessary to look at the quality of the environment because this is not an area identified for the inspection of a Nurses Agency. 7
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How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focussed inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under Quality Themes. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet Improving Care and Social Services in Wales. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. 9