Alzheimer's and Dementia Support Services, Safeharbour Memory Wellbeing Centre Also known as Support at Home - Plus

Alzheimer's and Dementia Support Services, Safeharbour Memory Wellbeing Centre (referred to in this report as ADSS) is a specialist domiciliary care service providing personal care to people living with dementia in their own homes. 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. The service was providing personal care to 44 people at the time of the inspection.

People’s experience of using this service and what we found

People received safe care from ADSS. Individual risks were assessed to support people to remain safe in their home. Medicines were safely managed and staff competence when giving people their medicines was regularly checked. Sufficient numbers of staff were available to provide people’s care and support and a safe recruitment process was in place.

The provider, manager and staff were keen to provide a good quality service that put people at the centre of care. Robust systems were in place to closely monitor people’s care and support to achieve this aim. A culture of continuous improvement was evident.

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 24 May 2019).

Why we inspected

We undertook this focused inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

At this inspection we only inspected the key questions for safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alzheimer's and Dementia Support Services, Safeharbour Memory Wellbeing Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Safeharbour; Memory Well being Center is a registered charity and provides personal care and support to adults living with dementia, and those who care for them, in their own homes in the Dartford, Gravesham and Swanley areas. The service provides support to enable people to live as independently as possible.

People’s experience of using this service:

People and relatives described a service that was person centred. People and their loved ones were fully involved in decisions about their care and how it was provided which made sure they received individually led care and support.

People had mainly the same core group of care staff to provide their support which meant that staff got to know people and their families well and what was important to them. People said they felt safe.

The training staff received meant they were skilled in their role and people felt confident they knew what to do and understood their needs. Relatives described how staff had a good understanding of how living with dementia affects people and how to tailor their support.

Staff were well supported by the provider and registered manager and they said this meant they were in a good position to provide good quality care.

People knew how to make a complaint and they had the information they needed.

People, relatives and staff described a well run organisation who had people at the heart of what they did.

Rating at last inspection:

Good (Report published 29 October 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will visit the service again in the future to check if there are changes to the quality of the service.

Alzheimer’s and Dementia Support Services is a registered charity. Their Support at Home Plus service provides personal care and support to adults living with dementia and those who care for them in their own homes in the Dartford, Gravesham and Swanley areas. The service provides support to enable individuals to live as independently as possible. At the time of our inspection 55 people were using the service. The main office is located in Northfleet, Kent.

There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 previous registered manager had left 3 weeks prior to inspection and had started the process to de-register with the CQC. Interim management cover had been put in place and support was being provided by the operations manager and chief executive officer. A new manager was being recruited and shortlisting for the post was due to start the week following the inspection. The chief executive officer told us that the newly appointed manager would be registering with CQC as soon as they had completed their initial induction and training.

People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual care plans, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged them to do as much as possible for themselves.

Staff sought and obtained people’s consent before they provided support. Relatives told us that staff communicated effectively with the people they cared for, responded to their needs promptly and treated them with kindness and respect. People and their relatives were satisfied with how their support was delivered.

People’s privacy was respected and people were supported in a way that respected their dignity and independence. People received the support they required to ensure they had enough to eat and drink to maintain their health and wellbeing.

Policies and procedures were available for staff to support practice. There was a whistle blowing policy and staff were aware of their responsibility to report any bad practice.

There were robust recruitment practises in place to ensure that staff were safe to work with people. Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns.

Staff had completed the training they needed to care for people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported.

Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of recurrence could be reduced.

People’s individual assessments and care plans were reviewed regularly with their participation. People’s care plans were updated when their needs changed to make sure they received the support they needed.

All members of care staff received one to one supervision sessions to ensure they were supporting people based on their needs. Staff told us they felt valued under the leadership of the chief executive officer and operations manager. However annual appraisals had not taken place, a new appraisal system was scheduled to start in October. We have made a recommendation about this in our report.

Medicines were stored, managed and administered to people in a safe way. There was regular auditing of medicines and staff competencies were checked to ensure standards were maintained.

The provider sought and obtained feedback from people and their relatives on the quality of the service. People and their relatives had access to the complaints procedure and knew how to make a complaint. The provider analysed the results and acted upon the comments they received.

The chief executive officer and operations manager notified the Care Quality Commission of any significant events that affected people or the service. Quality assurance audits were carried out to identify how the service could improve and remedial action was taken when necessary.

Relatives and people who use the service told us communication was good from the carers and service provider 'Open honest, good communication'.

We spoke with the registered manager about how checks were carried out on people's care plans to ensure that these were being maintained safely. The provider may find it useful to note that they were not always formally documenting these checks in order to evidence their assessment and monitoring of quality in this area.

The registered manager had introduced a system of monthly supervision for all staff. We reviewed completed supervision forms that staff had completed. Staff we spoke with confirmed that they found the supervision helpful to review and monitor their performance and the care of the people they were supporting.