The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Kincare

Overall: Good read more about inspection ratings

53 Bartholomew Street, Newbury, Berkshire, RG14 5QA (01635) 550611

Provided and run by:
Mrs Pamela Gladys Jenkins

All Inspections

6 October 2015

During a routine inspection

This inspection took place on 6 October 2015 and was announced. Kincare is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of inspection the service was offered to 34 people.

At the last inspection on 25 and 28 November 2014, we had told the provider to take action to make improvements to requirements relating to workers. This action had been completed.

There was 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.

People told us they felt safe. Safeguarding procedures were in place and staff knew how to respond to allegations of abuse.Care workers had a good knowledge and understanding of safeguarding and whistleblowing policies.

Staff felt they were adequately trained and were encouraged to look for ways to improve their work. They believed the recent change in management improved the overall quality of service. They spoke highly of the service, the registered manager and the people they worked with.

People's safety was promoted as risks that may cause harm in their home and local community had been identified and managed. Appropriate risk assessments were in place to keep people safe.

The service carried out assessments of people's needs before providing care to ensure their needs could be met. Care plans were in place and detailed people's support needs. Staff understood those needs.

People were supported by care workers to make their own decisions. People told us that their care was provided to a good standard. People were encouraged and supported by members of staff to make choices about their care.

Staff sought people's consent before carrying out care, treatment and support. People told us they were treated with consideration and respect. Staff we spoke with understood the need to protect people's privacy and dignity. There were many positive comments from people about staff. People's views showed that staff understood the importance of their role in supporting people and maintaining their independence and dignity.

People were protected from unsafe administration of their medicines because care workers were trained to administer medicines safely. All members of staff completed mandatory training to ensure they were competent to administer, store and dispose of medicines correctly.

People knew how to complain and told us they were happy to do so if this was necessary. Both people and care workers were encouraged to provide feedback on the quality of the service.

The provider had quality assurance systems in place to monitor the care and support people received. Systems were effective in identifying errors. Once identified, a senior staff member would investigate and resolve the concerns to people's satisfaction.

The registered manager was seen as a good leader, both by staff and by people using the service. The registered manager was trusted and had created a strong sense of commitment to meeting people's diverse needs and supporting staff.

25 & 28 November 2014

During a routine inspection

We undertook an announced inspection of the domiciliary care agency (DCA) Kincare on 25 and 28 November 2014. We told the provider two days before our visit that we would be coming. Kincare provides personal care services to people in their own homes. At the time of our inspection 29 people were receiving a personal care service.

At the last inspection carried out on 13 May 2014 we found the provider was not meeting the regulations in relation to medicines management, requirements relating to workers, supporting workers and assessing and monitoring the quality of the services provided. Following the inspection the provider sent us an action plan telling us about the improvements they were going to make by 1 October 2014. During this inspection we found the provider had taken action to address the breach of regulation. However, not all improvements were in place and some unacceptable practice remained.

The agency had a registered manager. 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.

We looked at the provider’s recruitment processes. It is the legal requirement for providers to obtain full employment history together with a satisfactory written explanation of any gaps in employment. Employment history and gaps were not fully explored or clearly recorded for newly recruited staff. The provider had not addressed any discrepancies that were found at the last inspection.

Management of medicines was improved however we still found some concerns with the accuracy of the records with regards to medicines.

Staff numbers to attend the visits were assessed according to people’s needs, the place where they lived and staff skills and experience. People and relatives were complimentary about staff’s support. However, some of them were not always informed about the changes to the visit and timings of the visit which had a negative effect on their daily routine.

The systems for ensuring staff had the required training had improved, however some staff had not had all of their training updates. Staff received support from the management that helped them understand and provide good quality care.

The provider had some systems in place to manage risks in a way that would balance people’s right to make choices with their right to be safe and independent. Staff were aware of the actions they needed take. However, clear guidance on how to support people to manage those risks and protect their safety, was not always recorded.

People were encouraged to take part in the planning of their care and to actively feedback on the support they received. People felt able to be open and honest with staff and the management team because good relationships had been built between them.

The registered manager had knowledge about the Mental Capacity Act 2005 (MCA). They understood and followed legal requirements regarding making choices and decisions, and making sure people’s rights and liberties were protected. Staff were following the principles of MCA when supporting people who lacked the capacity to make specific decisions.

Staff had good knowledge of people’s needs and preferences which contributed to the quality of the care and support provided to people. Each person was supported in the way they preferred and staff respected these preferences. People and relatives spoke positively about the service they received and praised the staff. We observed people being treated with kindness and respect. Staff told us they would challenge poor practice if it occurred and were confident it would be addressed by the registered manager People were appropriately supported to eat and drink. Staff supported people to look after their health and liaised with their GP and other healthcare professionals, as required to meet those needs.

The registered manager had quality assurance systems in place to monitor the quality of the service provided. This was linked to a learning culture where staff and people were encouraged to comment on the running of the service. Any feedback received, incidents and accidents were shared with the team. They were discussed to try to prevent them from happening in the future. Staff told us the registered manager was supportive and approachable. They were confident any issues would be addressed promptly.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

13, 16 May 2014

During a routine inspection

One inspector visited the agency and gathered evidence against the outcomes we inspected to help answer our five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who use the service, their relatives, the staff and management supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt the staff supported them well and they trusted the staff who came to support them. People who use the service told us they felt respected and had good communication with the agency.

Some systems were in place to make sure managers and staff learned from events such as complaints, concerns, safeguarding and investigations. This would reduce the risks to people and help the service to continually improve.

Staff knew how to care for people and help remain safe. People who use the service also had choice and control of their lives and how their support was planned.

Recruitment practice and checks were not always thorough and safe. Policies and procedures were in place however they were not always followed.

Staff training arrangements were not always in place. The training was not monitored to make sure staff had their skills and knowledge updated at the right time. There was a risk staff would not always have the right skills and experience to ensure people's needs were always met.

Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS). Following a recent Supreme Court judgement this legislation now applies to supported living settings. We spoke about this with the provider. They were aware of this judgement relating to 'deprivation of liberty'. They confirmed to us they would make contact with the local authority DoLS team, regarding the implications to make sure people were safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in planning their own care and support. If there were any specific needs identified, this was followed up and noted in the care plan. People told us they had a care plan with their needs and support identified.

Staff were able to meet people's individual needs in a timely manner. However, the agency did not always make sure staff were trained appropriately.

People we spoke with were complimentary about the care they received. They said the staff respected them, looked after them and communicated well. They made comments such as: 'Oh yes, they are all very kind and helpful, never afraid to ask for help', 'Yes, staff respect me and talk to me' and 'Oh yes, staff know what they are doing and I tell them'.

Is the service caring?

We spoke with people who use the service about their staff. The feedback they gave us was positive including, 'Very approachable people and do splendid job' and 'Very happy with the staff'.

We spoke with staff who were able to tell us how they cared for the people who use the service. People told us they completed some surveys or spoke to the management on the phone, or in person, to give feedback about the service they received. People told us their preferences were acted upon.

Is the service responsive?

People told us they knew how to make a complaint or raise an issue with staff and managers. They knew how to contact the provider if they needed help or advice. We looked at investigations carried out in regards to issues or complaints raised. We saw actions and investigations were carried out but not always followed up with staff to address the problem.

We saw the agency worked with other services and professionals to make sure people received care and support.

Is the service well-led?

The provider had a quality assurance system in place. However, records we looked at showed that the service did not always have processes to identify problems and procedures to act on any concerns identified.

Staff we spoke with told us they were clear about their role and responsibilities. They told us they were supported in their job which helped to make sure people who use the service received care and support of good quality.

7 November 2013

During a routine inspection

We looked at people's care plans and supporting documents. We found that people's care plans detailed their care and support needs, and how to meet those needs, whilst daily reports reported on each person's wellbeing. We told the provider that we had found some errors within people's records where medication records were not always signed.

People who used the services told us they felt safe, cared for and listened to by staff. Comments included, 'staff are really kind and thoughtful' and 'I would not hesitate to contact the agency if I had a concern'.

We found staff were knowledgeable of people's support and personal care needs and had received training to update their skills and knowledge. We told the provider that staff training had not been reviewed to include the Mental Capacity Act 2005, which enabled staff to understand the aspects of protecting people which were relevant to them.

The agency had systems for monitoring the services provided. People told us they had opportunities to contribute their views about the quality of the service and that they were listened to. Comments from people included, 'can't find any fault in them' and 'the carers are all very helpful'.

7 August 2012

During a routine inspection

We spoke with six people who used the service and one relative of a person who used the service. People told us that their privacy and dignity was maintained and they were always treated with respect. People told us that the agency generally gave a good service. They told us that the care staff usually arrived and left on time. One of the seven people spoken with said that time keeping was a problem, on occasion. All of the seven people spoken with told us that said that in general they were very happy with the care they received. People told us that they fully trusted and were very comfortable with the carers in their homes. People said that the staff were ''lovely'' and they were ''treated extremely well''. Five of the people spoken with told us that they had no complaints at all about the service. Others said that they felt there were some organisational and communication issues. They said that whilst these meant that care was not given by regular carers at the correct times it did not impact on the quality of care that individual staff delivered. Six of the seven people spoken with told us that their views were listened to and actions were taken, as necessary.

2 November 2011

During a routine inspection

People told us that they were treated with respect by staff, and were involved in the decisions made about their care. They told us that they had no concerns or worries about the care they received and that they could approach staff if they were worried or concerned.