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Inspection carried out on 5 July 2017

During a routine inspection

This announced inspection took place on 05 and 07 July 2017. Carers’ Support (Bexley) provides respite breaks for family carers across the London boroughs of Bexley and Greenwich. At the time of the inspection 42 people were receiving personal care. We previously carried out an announced inspection of this service on 24 April 2015 and the service was rated good overall.

The service had a system and process to assess and monitor the quality of the care people received. The service carried out spot checks, conducted phone calls to people’s homes and reviewed areas such as the administration of medicines, health and safety, care plans and risk assessments. The service sought the views of people and their relatives to improve the quality of the service.

However, at this inspection we identified some improvement was required in specific areas related to the management of the service. The provider’s medicines policy was incomplete and they had not maintained a manual or electronic call monitoring (ECM) system to show that they had monitored visits to people’s homes to ensure they received visits at the correct times and for the required duration. As a result of the inspection feedback the registered manager confirmed with us that they had arranged to review and update the medicines policy and said that they have now introduced a call monitoring log. We shall assess the impact of this at our next inspection.

The service had 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. The registered manager demonstrated good knowledge of people’s needs and the needs of the staff team. Staff described the leadership at the service positively.

People’s relatives told us their family member’s felt safe with the staff. The service had clear procedures to recognise and respond to abuse. All staff completed safeguarding training. Senior staff completed risk assessments for people who used the service which provided guidance for staff to minimise identified risks. The service had a system to manage accidents and incidents to reduce reoccurrence.

The service had enough staff to support people and carried out satisfactory recruitment checks before they started working. The service had an on call system to make sure staff had support outside the office working hours. Staff supported people so they took their medicines safely.

The service provided an induction and training, and supported staff through regular supervision to help them undertake their role.

People’s consent was sought before care was provided. The registered manager was aware of the requirements of the Mental Capacity Act 2005 (MCA). At the time of inspection they told us they were not supporting any people who did not have the capacity to make decisions for themselves. Care records we saw confirmed this.

Staff supported people to eat and drink enough to meet their needs. People’s relatives coordinated health care appointments to meet people’s needs, and staff were available to support people to access health care appointments if needed.

Staff supported people in a way which was caring, respectful, and protected their privacy and dignity. Staff developed people’s care plans that were tailored to meet their individual needs. Care plans were reviewed regularly and were up to date.

The service had a clear policy and procedure for managing complaints. People knew how to complain and would do so if necessary.

Inspection carried out on 15 & 16 April 2015

During a routine inspection

This announced inspection took place on 15 and 16 April 2015 and was followed by phone calls to people who used the service and their relatives on 23 and 24 April 2015.

Carers’ Support (Bexley) provides respite breaks for carers in their homes across the London boroughs of Bexley and Greenwich. There were 32 people receiving personal care at the time of our inspection visit.

We last inspected Carers’ Support (Bexley) in November 2013. At that inspection we found the service was meeting all the regulations that we inspected.

A registered manager was in post at the time of our inspection. 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.

There were clear procedures in place to recognise and respond to abuse and care workers had been trained in how to follow these. Risk assessments were in place and reflected current risks for people who used the service and ways to try and reduce these. Appropriate arrangements for the management of people’s medicines were in place and care workers received required training in administering medicines.

Care workers received a thorough induction and training to help them undertake their role and were supported through regular supervision and appraisal. We saw care workers had received training in the Mental Capacity Act (MCA) 2005

Care plans were in place and were reviewed with people and or their relatives to ensure the care provided was appropriate for people.

Care workers knew people’s needs and preferences well and treated people in a kind and dignified manner. People and their relatives told us they were happy and well looked after. They felt confident they could share any concerns and these would be acted upon.

There was a positive culture at the agency where people felt included and consulted. People and their relatives commented positively about the service they receive. There was an effective system to regularly assess and monitor the quality of service provided.

Inspection carried out on 28 November 2013

During a routine inspection

All the people we spoke with told us that care workers looked after them well, and supported them as and when required to meet their health and social care needs. They told us that they never had any problems, no complaints and they can’t speak highly enough about the service. One relative told us “they are invaluable to me, I’m ill myself and can’t lift mum, so we have two (care workers) at a time and they are absolutely marvellous with her”. Another relative said “ I have watched my daughter come out of her shell as she plays with these volunteers (care workers); they take her out, play games with her”. A third relative told us “they give me a chance to get out and have a life – the girl (care worker) we have is amazing with my wife, I have total peace of mind leaving her”.

We found that people’s health and social care needs were assessed and that care was delivered in line with their individual support plans. People received care, treatment and support they agreed to. People experienced care that met their needs and were cared for by suitably qualified, skilled and experienced care workers. The provider had completed all appropriate checks for care workers before they began work. People were protected from the risk of abuse, and the personal records were fit for purpose and stored securely.

Inspection carried out on 29 January 2013

During a routine inspection

People we spoke with told us they were very happy with the quality of service they received and that the work of the organisation made a difference to carers’ lives. We found that staff respected people’s privacy and provided care with dignity and respect. A relative told us their family members "dignity is promoted which helps in regaining their confidence". We found that people who use the service were involved in planning their care and they received personalised care and support based on their assessed needs. People were able to state their preferences which were respected by staff. One carer told us “I am very much involved in the care planning…and we also have a copy of the care plan at home which is reviewed on regular basis”.

People told us they felt safe and had no concerns. A carer told us the service provided was a “lifeline” and they knew their family member was “in safe hands”. People told us staff arrived on time and if they were running late staff would contact them to let them know. We found that appropriate training and support was in place for all members of staff including volunteers. A family member told us “the service is absolutely wonderful to my life as carer, knowing my son is being cared for by people who are properly trained”. We found the provider regularly assessed and monitored the quality of care provided through regular phone calls to people, staff supervision, care notes and annual surveys.

Inspection carried out on 14 September 2011

During a routine inspection

People we spoke to told us that they had been given information about the organisation and had been involved in the assessments and care planning processes.

Privacy and dignity was respected and people felt they had good working relationships with the respite carers. A family member told us “it is good for my mum to have someone who is different”.

People felt safe and comfortable with the respite carers, and were satisfied with the level and quality of services being provided.