Archived: Kensington Community Care (Bristol)

Updated 10 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection team consisted of one adult social care inspector.

Prior to the inspection we looked at information we had received about the service since the last inspection. This included information passed to us by the service themselves, the safeguarding adults team and other health and social care professionals. The comments they made about the improvements made in the service have been included in the main body of the report. We also looked at the notifications submitted by the service. A notification is information about important events which the service is required to send us by law.

We looked at the Provider Information Record (PIR) submitted by the service on 5 November 2018. This is a form that asks the provider to give some key information about the service, tells us what the service does well and the improvements they planned to make. The information provided was detailed and included all the areas where improvements had been made since the last inspection.

During the inspection we spoke with the manager, the two care coordinators and the operations manager. We also spoke with four home care assistants, four people who received a service in their own home and three relatives. We looked at six people’s care records, three staff recruitment files, training records for the whole staff team, key policies and procedures and other records relating to the management of the service.

Updated 10 January 2019

This inspection started on 5 December 2018 and was announced. We gave the service 24 hours notice of the start of the inspection because we wanted key people to be available. The service was last inspected in April 2018. At that time, we found there were four breaches of regulations. The service was rated as Inadequate and was placed in special measures.

When we place services in special measures we expect providers to take action to significantly improve the quality and safety of their service. Services placed in special measures will be inspected within six months and kept under review during this period. The purpose of this inspection is to check the service had improved and to provide a new quality rating. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At the time of this inspection the service was providing support to 36 people who lived in their own homes. The service had previously handed back, to both Bristol City Council and South Gloucestershire Council, funded care packages to enable the service to stabilise and improve. The service was provided to people who lived within the South Gloucestershire and Bristol local authorities. The service employed 23 care staff but were actively recruiting to enable the service to expand again.

There was no registered manager in post, however an application to be registered with CQC had already been submitted and accepted. 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 manager will be registered to carry on the regulated activity at two branches – Bristol and Birmingham. They will be supported by a deputy manager in both branches.

The findings from the inspection have been very positive. Significant improvements have been made. The office had been tidied up and was organised. The atmosphere in the office was good and the staff were working together for the benefit of the people they were providing a service to.

Why we have rated the service Good ?

The service was safe. Care staff had received further training about safeguarding adults and were fully aware of their responsibilities to protect people. They knew what to do if safeguarding concerns were raised. The service followed safe recruitment procedures to ensure unsuitable staff were not employed.

The management of medicines had been significantly improved and care staff had been trained to administer medicines safely with their competence checked. However, we recommend that protocols be put in place to give guidance to care staff where they need to help people with ‘as required’ medicines.

The service was responsive. Significant improvements had been made to ensure that people received a person centred service. People’s care and support needs were assessed so that their care plan could be agreed with them. People were involved in making decisions about how they wanted to be looked after. Risks to people’s health and welfare were assessed and measures put in place to reduce or eliminate the risks. Where people needed support with their meals and drinks, their needs were assessed and detailed in their care plan. Care staff assisted people to make contact with any health care professionals and their GP as necessary. People’s care and support needs were reviewed and their care plans were amended as necessary.

The service was effective. The provider had a four day induction training for new staff to complete and this was in line with the Care Certificate. All other staff had a programme of refresher training to complete and records evidenced the training staff had completed. Staff were supervised and their work performance was spot checked. These measures ensured the staff team had the appropriate skills and knowledge to meet people’s care and support needs.

Care staff asked people for consent before they provided care and support and we found the service was working within the principles of the Mental Capacity Act 2005.

At this inspection, we found that the service was caring. Better work planning meant people were supported by the same care staff or the least number of care staff. This provided people with a consistent service and feedback we received from them was good.

People were encouraged to have a say about the service and could do this during their care plan review meetings, quality assurance surveys and via the provider’s complaints procedure. Those complaints the service had received since the last inspection had been handled correctly.

At the last inspection, we found there was a lack of leadership and management of the service and the culture amongst the staff was poor. This had been due to many management changes and incompatible office staff. The provider has taken appropriate action since the last inspection. The previous registered manager had returned to the branch and there were two new care coordinators in post. The measures to monitor the quality, safety and ‘customer’ satisfaction with service provision had been re-introduced and the provider had set up processes to ensure they kept an overview of how the service was performing. There was a regular programme of auditing and people were being asked to provide feedback regarding their views and opinions of the service.