Expertise Homecare (Central & West Kent) Ltd

Expertise Homecare (Central & West Kent) Ltd is a domiciliary care service registered to provide personal care for older people, people who live with dementia, people who have learning disabilities or autistic spectrum disorder and people who have a physical disability. At the time of our inspection 65 people were receiving personal care.

Not everyone using the agency received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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

People and their relatives told us they were frustrated with the lack of consistency with care staff. The registered manager had been made aware of several concerns with the interim management team whilst they were on maternity leave. The registered manager decided to return to the business early and had started to implement changes to improve the quality of care people received. Recruitment and retention processes were amended to retain staff, enabling people to receive continuity of care.

People, relatives and others had been asked for their views about the service. As a result, the feedback an action plan had been developed to improve the service people received. The registered manager had increased staff morale and the retention of new staff.

Recruitment of care staff was underway to address the shortfall. Safe recruitment practices were followed to reduce the risk of unsafe staff working with people. Staff received continuous support, supervision and guidance from their line manager. Staff were trained to meet people’s needs including their specialist needs.

People’s needs were assessed before they started using the service to make sure staff could meet their needs. Care plans were personalised to meet people’s needs. People were involved in the development and review of their care plan.

Staff worked alongside healthcare professionals to ensure people remained as healthy as possible. Guidance was available to inform staff how to meet people’s specific health needs. People's personal information was stored securely.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. People were able to make decisions about their care and support and to maintain control of their lives.

People felt safe with staff who understood the action to take if they suspected potential abuse. Potential risks posed to people had been assessed with action taken to reduce the risk. People’s safety within their home had been recorded, and referrals were made to the appropriate healthcare professionals to promote people’s safety.

Staff treated people with kindness, care and compassion. People’s likes, dislikes and personal histories were recorded within their care plan. People’s privacy and dignity was protected whilst encouraging people to be as independent as they were able to.

People’s feedback, concerns and complaints were listened to and acted on. There were a range of checks and audits in place to promote a high-quality service and continuously improve.

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 overall with Outstanding in responsive (published 23 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

Expertise Home Care (Central & West Kent) Ltd provides care and support for people in their own homes. This includes older people, people with a learning disability and people with a physical disability. The office is situated in the centre of Maidstone. At the time of our inspection, the service was supporting 63 people.

At the time of our inspection, there was a registered manager in place who was also the provider and owner of the organisation. 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 and the relatives spoke highly of the service they received. Staff, the registered manager and the management team were motivated and passionate about providing a high quality service to people. The registered manager was committed to providing a high quality service to people and its continuous development. Feedback from people, their representatives and others were continually sought and used as an opportunity for improve the service people received.

The safety of people using the service was taken seriously by the registered manager and staff who understood their responsibility to protect people’s health and well-being. Staff, the registered manager and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s and staff’s safety both internally and externally to the person’s home had been assessed and recorded, with measures put into place to manage any hazards identified. Staff were available to meet people’s assessed needs.

The provider developed an innovative online software system which was used to store the information staff required to meet people’s needs. This was stored within an electronic encrypted tablet which, each member of staff carried with them. Measures were put into place to address people’s hopes, dreams and wishes. People, their relatives and staff were included in the development of the service.

Staff had received the training they required to meet people’s needs. A comprehensive induction programme was in place which all new staff completed. Staff had a clear understanding of their roles and people’s needs. Staff were supported to progress and develop in their role from the management team. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

Where staff were involved in assisting people to manage their medicines, they did so safely. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

Staff had a full understanding of people’s care and support needs and had the skills and knowledge to meet them. People received consistent support from the same group of staff who knew them well. People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff within their electronic tablet about how to provide all areas of the care and support people needed.

People were supported to remain as healthy as possible. Guidance was available within people’s care plans to inform the staff of any specific health condition support. People were encouraged to maintain as much independence as possible.

People were treated with dignity and respect whilst receiving care and support from the agency. Staff understood the principles of the Mental Capacity Act 2005 and people and/or their relatives said they were always asked their consent before any care or support tasks were carried out.

Systems were in place for monitoring the quality and safety of the service and assessing people’s experiences. These included telephone reviews, face to face reviews and annual questionnaires. People were encouraged to raise any concerns or complaints they had which were acted on.