Archived: Kaleidoscope South Hams Limited

We carried out this inspection on 14 and 17 October 2016 and it was announced four days in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. The service was last inspected in February 2014 and was found to be meeting the Regulations.

There was a registered manager in post who was responsible for the day to day running of the service. 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.

Some people who used the service were not able to tell us their views about the care and support they received. However, we observed people were relaxed and comfortable with the staff supporting them. Comments from people who were able to talk with us included, “I am very happy”, “I am getting on OK” and “I like all my staff.” Relatives told us they were happy with the care and support their family member received and believed they were safe. One relative said, “I haven’t got any complaints, everything is absolutely fine.”

Staff were recruited safely, which meant they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. Staff were employed to work in specific teams and each team supported a small group of people using the service. Where people had particularly complex needs only staff trained to meet their needs were allocated to work with them.

Care plans provided staff with direction and guidance about how to meet people’s individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Staff told they were kept informed of people’s changing needs. Any risks in relation to people’s care and support were identified and appropriately managed.

Staff supported people to access specialist services such as occupational therapists, epilepsy nurses and dieticians. Relatives told us they were confident that the service could meet people’s health needs. Staff supported people to maintain a healthy lifestyle where this was part of their support plan. People were supported by staff with their menu planning, food shopping and the preparation and cooking of their meals. People were supported to access the local community and told us they took part in activities that they enjoyed and wanted to do.

The registered manager had a clear understanding of the Mental Capacity Act 2005 (MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. Mental capacity assessments and best interest meetings had been carried out as required. Management had identified where it might be necessary to apply to the Court of Protection to authorise a deprivation of liberty and had highlighted this to the local authority. This was because some people had restrictions in place, in relation to when they could go out, in order to keep them safe.

There was a management structure in the service which provided clear lines of responsibility and accountability. There was a positive culture within the staff team and staff spoke passionately about their work. Staff were complimentary about the management team and how they were supported to carry out their work. Staff commented, “They are a good company to work for, there is good communication” and “They are brilliant and they really look after their staff.”

Relatives were positive about how the service was managed, commenting, “I speak with [person’s name] manager regularly and they keep me informed of any concerns” and “The organisation is well run.”

People and their relatives said they knew how to make a formal complaint if they needed to but felt that issues would be resolved informally as the management and staff were very approachable. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We found people's preferences had been sought by the service and were used when planning their care. People were offered choices and their wishes were respected.

People's consent was sought prior to care taking place and where people lacked the capacity to make decisions best interest meetings were held and consent was gained from the appropriate people.

Care plans contained detailed information about people's individual needs and these were updated to reflect any changes. Specialist advice was regularly sought and used in the planning of people's care.

The service had ensured staff were of good character and possessed appropriate experience prior to starting work and the service had systems in place to monitor the quality of the service they provided.

We spoke with seven staff including the Chief Executive Officer, the General Manager, two Assistant Managers, one Support Worker and two bank staff. Staff told us that they felt supported in their job and were aware of support and supervision systems available to them.

Staff told us about the mandatory training they had received to support them in meeting people's specific needs. We saw the plan for training that was arranged to be delivered to staff in the coming year.

The provider had clear policies and procedures for staff to follow which protected people who used the service from the risk of abuse. Everyone we spoke with said they felt safe. They said if they had any complaints they would confidently talk to staff and resolve it with them.

We were told that people's support plans were in their own homes. This enabled staff to refer to individuals' specific needs and goals when they were providing support to them.