We carried out a review of the data available to us about Kent Enablement at Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kent Enablement at Home, you can give feedback on this service.
Kent Enablement at Home provides short term care to adults and older people, including those discharged from hospital. The service generally supports between 100 and 140 people at any one time. The service was split into two areas and each area had its own team led by a locality organiser. On the day of our inspection 109 people were using the service.
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.
People’s experience of using this service and what we found
People told us they felt safe. People were protected from abuse and avoidable harm and risks to people were managed. The management team promoted an open culture to encourage staff to raise any concerns.
The service was rated requires improvement in safe at their last inspection as some staff pre-employment checks had not been completed. At this inspection we found staff were recruited safely and there were enough staff to meet the needs of people. People received all their scheduled visits and staff stayed for as long as the person needed. Medicines were managed safely and there was learning from accidents and incidents.
People's needs were assessed, monitored and reviewed to ensure their needs were met. People were supported by competent, knowledgeable and well-trained staff. Staff were supported by the management team.
Where required people were supported to ensure their dietary needs and preferences were met. Staff worked closely with occupational therapists and other agencies to assess people’s needs and ensure people were supported with their enablement.
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 relatives were happy with the care they received and were highly positive about the service and its staff. People’s equality and diversity needs were respected, and they were involved in decisions about their care. People’s privacy, dignity and independence was promoted by staff.
Care was person centred and had good outcomes for people. Over 55% of people who used the service were enabled back to independence and had no on-going care needs. People were supported with their communication needs. People were supported to develop meaningful activities and to avoid becoming socially isolated. Feedback about the service was very good but people could complain if they needed to.
There was a caring and open culture in the service. People, relatives and staff were all positive about the management team and the service provided. The governance framework had ensured the delivery of high quality and safe care. Feedback was analysed and used to make improvements to the service.
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 15 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.
The service required 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. There was a registered manager in post.
The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults.
We found that recruitment practices were in place, however we found that the service’s own policies were not always followed surrounding completion of pre-employment checks prior to a new member of staff working at the service. Staff received regular training to enable them to work safely and effectively
All of the responses from people who spoke with us was that the service was either very good or excellent. People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff arrived on time and stayed for the length of time allocated and that an on-call system was always available.
Each person we spoke with knew their care plans and said that they were involved in the assessments, each person also told us that all care was provided with their consent.
The staff employed by Kent Enablement at Home knew the people they were supporting and the care they needed. People who used the domiciliary service and staff told us that Kent Enablement at Home was well led and staff told us that they felt well supported in their roles. We saw that the manager and the senior staff were a visible presence and it was obvious that they knew the people and staff who they supported really well.
Suitable processes were in place to deal with complaints and people knew how to access the information, however each person we spoke to had no complaints about the service.
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 findings during the inspection, discussions with two of the people using the service, four care staff and two supervising managers. We looked at five people's care records. If you wish to see the evidence supporting our summary please read the full report.
The service was safe. People who used the service told us that they felt safe. One person told us, "I feel 100% safe with the support staff, they are all so lovely". Safeguarding procedures were in place and staff spoken with showed they understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.
People's independence, rights and choices were protected because the provider had procedures in place to gain people's consent to the care and support they received.
Staff knew about risk management plans and we saw that they supported people in line with those plans. This meant that people were supported with their care needs in a way that was intended to ensure their safety.
The manager ensured that staff rotas were planned in advance to maintain the staffing levels required. Extra support could be made available if necessary. Systems were in place to make sure that accidents, incidents and complaints were recorded and acted on as soon as possible and checks were made on aspects of the service. This enabled the management to make changes when required to improve the service provided.
The service was effective because people's care needs were assessed with them. All of the people we spoke with told us they were involved in their care planning. We saw that care plans were updated as required should changes to needs occur. People had been assessed for capacity where required and staff were aware of the need of a best interest meeting if the need arose.
Where people had complex needs that required the input of specialist health care services, assessments had been made by the appropriate professionals. Their recommendations were carried out by the staff. This meant the provider worked with other services to ensure people's health care needs were met.
The service was caring because people were supported by care staff that were kind and caring. We saw that care staff gave people encouragement and respected their privacy and dignity. One person told us, "I am always treated with respect by all the staff".
People's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes.
The service was responsive. People were asked their views about the service and the provider acted on comments and suggestions that people made.
Where care staff had noticed people's changing needs, their care plans were updated to reflect this. This was because staff discussed people's care needs with them on a regular basis. People told us staff would always do their best to make sure they were happy. The staff spoken with told us that their times on visits were very flexible and if a person needed more than the allocated time, they were supported to stay and complete what was felt necessary. Other visits were then offered to other carers to ensure all care needs were met.
The service was well led. The provider had quality assurance and risk management systems in place.
The provider sought the views of people who used the service after the completion of each package. Records seen by us showed that people had been very happy with the service provided.
Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure that people received a good quality of care. Staff told us the service was well organised and they felt supported by their manager.
People told us that staff provided them with enough information to make choices about their care, and kept them informed about any changes to their care. We saw that care records included an agreement detailing the care to be provided, signed by the agency and the person receiving care.
We reviewed eight care records out of a total of 80, and found that all of them contained care plans which had been written and regularly reviewed based on assessments of each person's needs. We spoke with staff members who said that they referred to the care plan and risk assessments regularly to ensure they were able to meet the person's needs.
People told us that they felt safe with the carers from the agency, and staff told us that they had received suitable training in protection of vulnerable persons.
Staff members told us that they felt well supported by the management team and their colleagues. We noted that a range of training programmes was available to staff at the agency, and all new staff completed an induction programme which followed national guidance.
We found that the provider had implemented ways to gather feedback on the service from people, as well as monitoring the quality of the service provided through spot checks and staff appraisals.
People who use the service felt supported to make decisions for themselves and were encouraged to be independent. One person who uses the agency said 'They give me support, help I need to get me back on my feet'. Another said when referring to the staff that supported them said 'They are lovely people. I am happy with them'.
People told us they received care from a small team of staff and were happy with the care received and had no concerns relating to the staff.
We spoke to a member of staff working in the community. They told us that they try to empower people with knowledge and make them aware of the potential outcomes of all options. They went on to say that where people were no longer able to make decisions for themselves they spoke to others who know the person well including their family and GP about what they think the person may want and any previous preferences.