Archived: Kardinal Healthcare Limited

Kardinal is a domiciliary care agency and provides personal care to people living in their own homes. It provides a service to older adults, people who lived with dementia, people who lived with learning disabilities and younger adults with physical disabilities. At the time of the inspection, the service was supporting 149 people in We are Arun, Adur and Worthing. Not everyone using Kardinal Healthcare Limited receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating and drinking.

At the last inspection in June 2016, the service was rated Good. The key question well-led required improvement as there was no registered manager.

There was now 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 and associated Regulations about how the service is run.

At this inspection we found the service remained Good.

People told us they were very satisfied with the care and support that Kardinal Healthcare Limited provided. People told us, “Yes they just make sure I am comfortable and safe for the day,” and, “Very safe.”

There were systems to protect people from harm, including how medicines were managed. Staff had been trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team. Safe recruitment processes were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people. Risks to people's safety were assessed and managed to keep them safe. People were supported by sufficient numbers of a well-trained staff group who arrived on time and supported them in the time allocated in their care package. People who received medicines were supported in a safe way as staff had had the necessary training to administer medicines safely. They were protected from the risks of infection through good working practices by staff.

People's care was delivered in line with legislation and evidenced based practice. People who used the service had the capacity to make decisions about what they did and the choices they made. Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. People were supported to have choice and control of their lives and staff supported people in the least restrictive way possible: the policies and systems supported this practice. Staff received regular training in all aspects of their role and received regular supervision from the registered manager. Where people were supported with their nutritional needs, staff showed a good awareness of their dietary needs and where to get further support should this be required. Staff worked with people, their relatives and health professionals to manage people's health needs, making appropriate referrals for individuals when necessary.

People told us they were treated with kindness and said their privacy and dignity was respected. Comments included, “It makes me feel that I have someone there, someone to turn to if needed.”

Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices. Staff had developed meaningful relationships with people they supported. Staff knew people well and had a caring approach. People were treated with dignity and respect.

Care plans provided information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs. Changes in people’s health care needs and their support was reviewed when required. People were involved in reviewing care plans with the management team.

People’s views about the quality of the service were obtained informally through discussions with the registered manager, annual care reviews and formally through questionnaires. Staff felt supported by the registered manager and could visit the office to discuss any concerns.

There were systems to monitor the quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

Kardinal Healthcare Limited is a domiciliary care service which provides personal care to people in their own homes. The registered office is in Worthing however the service provides personal care across West Sussex including Littlehampton, Southwick, Henfield and Worthing. At the time of our visit the service was supporting 70 people including both children and adults with personal care. People had various needs, including dementia and/or a physical disability.

The manager had been in post since November 2014 however there had been no registered manager since 7 December 2015. 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. As this is a condition of the provider’s registration to carry out the regulated activity of personal care we have advised the manager accordingly that this is required. We have applied a ratings limiter to the Well-Led section of the report in response to this.

People told us that they felt Kardinal Healthcare provided a safe service. Staff were able to speak about what action they would take if they had a concern or felt a person was at risk of potential abuse or neglect. However training in safeguarding children had not been completed or updated by all staff who required it. We made a recommendation to the provider so that the appropriate action would be taken to ensure all staff supporting children attended safeguarding children training. The manager told us the action they were taking to rectify this.

People and relatives spoke positively about the support they received from the service and records reflected there were sufficient staff to meet people’s needs. The service followed safe recruitment practices. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks. People’s medicines were managed safely.

Staff felt confident with the support and guidance they had been given during their induction and subsequent training. Supervisions, appraisals and competency assessments were consistently carried out for all staff supporting people. .

People’s consent to care and treatment was considered. Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions.

Some people received support with food and drink and they made positive comments about staff and the way they met this need.

Staff spoke kindly and respectfully to people as well as involving them with the care provided. Staff had developed meaningful relationships with people they supported. Staff knew people well and had a caring approach. People were treated with dignity and respect.

Changes in people’s health care needs and their support was reviewed when required. If people required input from other healthcare professionals, this was arranged.

People received personalised care. People’s care had been planned and individual care plans were in place. They contained information about people’s lives, including their personal histories. They provided clear guidance to staff on how to meet people’s individual needs. People were involved in reviewing care plans with the management team.

People’s views about the quality of the service were obtained informally through discussions with the manager, annual care reviews and formally through questionnaires.

People told us that they knew who to go to make a complaint and how they would do so if and when they required.

During the inspection we found the manager open to feedback and enthusiastic about providing a high standard of care to people.

We found that staff had received training in safeguarding people from abuse. Staff told us that they knew how to identify and report concerns.

We saw that staff had the appropriate training and experience in order to deliver appropriate care.

The provider had systems in place to assess and monitor the quality of the service people received. People were 'very happy' with the service provided.

One person said "The carers are excellent, very caring." Another person said "I am very happy with the carers and I am very involved in the care planning process on behalf of my relative who receives the service."

We observed telephone conversations within the office where staff answered the phone promptly and spoke to the caller in a polite and courteous way. One person who used the service told us that the staff in the office were very approachable, polite and helpful.

People we spoke to told us that they had been made aware of the complaints policy and how to make a complaint. They stated that they have raised concerns in the past and they were always dealt with swiftly and to their satisfaction.

Staff we spoke to told us that they received regular supervision and that the senior team are available for advice and support. One person said "The senior staff are approachable and very supportive. I had to contact them twice in one night for support they were there for me."

We saw that staff received regular training appropriate to the needs of the people they support. The provider has in house trainers which enable a flexible approach to meeting the training needs of the organisation.