The inspection visit took place at the service’s office on 23 and 24 May 2016. Chameleon Care provides domiciliary care to people with physical disabilities, older people, people who are living with dementia and people who are terminally ill. There is also a sit in service, escorting, waking night and night sleep in service. The agency currently provides services in Dover and surrounding villages. There is also another location in Dartford, Kent. The service is open during office hours, has designated office-based staff and an on-call system. At the time of the inspection 35 people were receiving a service.
There was a registered manager employed at 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. The registered manager was responsible for overseeing the Dartford and Dover locations. The registered manager was based at the Dartford office and a senior manager was responsible for the day to day control of the Dover location. At the time of the inspection the senior manager and administration staff assisted the inspector.
People told us they received their medicines regularly and staff had been trained to administer medicines. However, medicine records were not completed accurately to clearly show that people had received their medicines safely.
Staff had received safeguarding training and demonstrated a good understanding of what constituted abuse and how to report any concerns. Procedures were in place to report and escalate any concerns to the local authority safeguarding team.
Risks associated with people’s care had been identified, and detailed guidance was in place to ensure that people were supported as safely as possible. Some people could display behaviours that challenge due to their anxieties and risk assessments were in place to guide staff with the strategies to adopt to positively support people when such occasions occurred.
There were systems in place to monitor incidents and accidents and to take appropriate action. There was a business continuity plan in the case of an emergency, such as fire, flood or the breakdown of the technical systems.
The service also operated an ‘out of hours’ system for people or staff to ring if they needed additional assistance during evenings and weekends.
Some people had equipment in place to aid their mobility, such as bathing aids. Staff were aware that the equipment needed to be serviced to remain safe, and systems were in place to confirm the equipment was being serviced according to the manufacture’s guidelines.
People told us that they had never experienced a missed call as there were always staff available including cover for sickness and annual leave. They told us that they received a service from regular staff, who arrived on time and stayed the duration of the call. People said the service was flexible and provided additional calls if they needed extra help.
Staff were recruited safely with all relevant checks in place to ensure they were safe and suitable to work at the service. New staff completed an induction programme, which included attending training courses and shadowing experienced staff before they started working on their own. People felt that staff were well trained and understood their needs. A training programme was in place to ensure that staff had the skills and competencies to carry out their role.
Staff were supported to discuss their role through regular one to one meetings with a senior member of staff. Annual appraisals ensured that staff had the opportunity to discuss their training and development needs. All staff received ‘spot checks’ when they were providing care in the community to ensure their skills and competencies were kept up to date.
People’s care needs were discussed and assessed before they received a service, and care plans were personalised to meet their individual needs. People told us that staff understood their specific care needs and their care plans were reviewed regularly. Care records showed that the plans had been reviewed and staff were aware of their changing needs.
People were supported to maintain good health. People told us staff were observant and helped them to ring their doctor if they needed to. The service worked closely with health care professionals, such as physiotherapists and an occupational therapist.
Staff had received training about the Mental Capacity Act 2005 and understood when and how to support people’s best interest if they lacked capacity to make certain decisions about their care. People told us that staff always asked for their consent at each visit. People had also signed and agreed with the care to be provided as part of their care plan.
People told us that they chose what they wanted to eat and were supported by staff to prepare their meals. Measures were in place to support people at risk of poor nutrition with measures such as monitoring their food and fluid intake.
People told us staff were very kind and caring. They said they understood their daily routines and how they liked their care to be given. People we visited were relaxed with the staff and chatted to them about their care. They told us that the staff were polite and respectful and treated them with dignity at all times.
People told us they did not have any complaints but would speak to staff in the office if they had any concerns. They said that staff listened to them and sorted out any issues. Each person had a copy of the complaints procedure in their care plans in their home, and appropriate systems were in place to address any complaints.
People and staff told us that the management were approachable and felt the service was well led. Staff understood the ethos of the service by providing person centred care and treating people with dignity and respect.
There were systems in place to monitor the safety and quality of the service and risks were audited to keep people as safe as possible.
We found one breach in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of this report.