19 September 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection team consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 25 July 2019 and ended on 1 August 2019. We visited the office location on 25 July 2019.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and eight relatives about their experience of the care provided. We spoke with 11 members of staff including the provider, three managers, human resources and quality administrator, and care workers. The provider was the nominated individual who was supporting the service whilst the registered manager was away. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 13 people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who have had regular involvement with the service.
19 September 2019
About the service
Kemble Care is a domiciliary care agency providing personal care for people with dementia, and/ or older people, physical disabilities, sensory impairment, and younger adults living in their own homes. The service was supporting 97 people at the time of our inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. Some people received visits and other people had staff live with them over a period of time.
People’s experience of using this service and what we found
People were cared for by staff and management team who were passionate about supporting people. They demonstrated boundless empathy and understanding. People were supported by staff who were warm and considerate towards them, who people considered friends. The management team and staff consistently went the extra mile and followed the ethos of “Giving something back.” Excursions, events and experiences were arranged to improve people’s well-being. There was innovative use of technology to improve communication and people’s health and well-being outcomes. The management team and staff lead on improving people’s independence and facilitating meeting people’s cultural beliefs and wishes. People and their relatives felt involved and supported in decision making. People's privacy was respected, and their dignity maintained.
People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Skilled, knowledgeable staff were available to meet people's needs. People’s risks were assessed and plans in place to guide staff. Safe systems were in place for the management of medicines when people needed support with this. Staff understood and followed infection control and prevention procedures. Incidents and accidents were investigated, and actions were taken to prevent recurrence.
People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance. Care was delivered by staff who were well trained and knowledgeable about people's needs and wishes. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and their relatives were positive about the service and the care provided. Staff provided care in a personalised way and worked with the management team to facilitate this. Suggestions and ideas were acted upon from people, families and staff. Staff and the management team were responsive to people's individual needs and flexed the service where possible to support people. People's concerns were listened to and action was taken to improve the service as a result.
The management team were open, approachable and focussed on providing person centred care. They completed checks to monitor and improve the quality of the service provided. The management team and staff engaged well with other organisations and had developed positive relationships. The management team worked on promoting strong community links to ensure people could access the support they needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 2 November 2016)
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.