Kent Enablement at Home

Updated 5 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 November 2017 and was announced. The provider was given short notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office. The registered manager was on leave on the day of the inspection.

The inspection team consisted of two inspectors and one expert by experience. The expert by experience spoke with people who used the service and their relatives by telephone. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We looked at previous inspection reports and notifications about important events that had taken place at the service, which the provider is required to tell us by law. The provider completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

We visited three people in their homes. We spoke with seven people over the telephone about their experience of the service and four relatives. We spoke with the registered manager over the phone and spoke with seven staff including two locality organisers, one enablement supervisor and four enablement support workers to gain their views about the service. We spoke with one senior occupational therapist practitioner and received feedback from six other health and social care professionals.

We reviewed four staff files, medication records, staff rotas, missed call logs, policies and procedures, compliments and complaints, incident and accident monitoring systems, meeting minutes, training records and surveys undertaken by the service. We looked at seven people’s care records, these included care plans, risk assessments and daily notes. We asked the provider to send us more information about audits. The provider sent the information to CQC in a timely manner.

Updated 5 January 2018

This inspection took place on the 27 November 2017 and was announced.

Kent Enablement at Home (KEaH) is part of the Social Care, Health and Wellbeing Directorate of Kent County Council. It is the in-house provider for support at home for older people and adults with a physical disability. The service has been designed for people who need support to regain their independence after a medical or social crisis. The service provides time limited support to people in their own home, for a period of three weeks initially. The service supports people who have been discharged from hospital, or those referred from the community. Support provided includes help with day to day tasks like cooking, shopping, washing and dressing and help to maintain their health and wellbeing. At the time of our inspection there were 65 people receiving the regulated activity of personal care from the service, living in the areas of Dartford, Gravesend and Swanley. People were funded through Kent County Council Social Services.

At the last inspection in November 2015, the service was rated Good in all domains and at this inspection we found the service remained Good.

There continued to be 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 also the operations manager of the service and covered the five registered locations, providing a similar service in other areas of Kent.

People continued to receive care from staff that were caring, kind and compassionate. People we spoke with told us they were positive about the support they received from the service.

People told us they felt safe. Staff continued to receive training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any concerns raised would be fully investigated to help ensure people were protected.

There were enough suitably qualified staff available to meet people's needs. The service was flexible and responded to people's changing needs. People told us they were able to request their visits at agreed times. People we spoke with told us they had never experienced a missed care visit.

People continued to receive care from staff who had the right knowledge and skills to meet their needs. People and their relatives spoke very highly of staff and comments included, "Nothing is too much trouble", "There is nothing to complain about", "They are kind and caring", "Staff are nice and helpful" and "Always willing to do what they can."

People’s needs were assessed and their care was planned to maintain their safety, health and wellbeing.

Risks were assessed and recorded by staff to protect people. There were systems in place to monitor incidents and accidents.

Staff were aware of people's preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. Staff treated people with dignity and respect.

We spoke with people who used the service and they told us the support workers always asked for their consent prior to completing care tasks. Staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

People continued to be supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff told us there was good communication with the management of the service. Staff said management were "Fantastic" and "Very supportive."

Procedures for reporting safeguarding concerns were in place. The registered manager knew how and when they should escalate concerns following the local authorities safeguarding protocols.

The provider had processes in place to monitor the delivery of the service. People’s views were obtained through surveys, one-to-one meetings, meetings with people’s families and social workers.

Staff continued to have good levels of support and supervision to enable them to carry out their roles.

Staff continued to be recruited safely through a robust recruitment and selection process in place. This enabled the provider to select staff that were suitable to work with people. Staff received an induction which included mandatory training and shadowing experienced staff.

The registered provider had a system in place to ensure people received their medicines as prescribed. Staff continued to receive training to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

There were policies in place which ensured people would be listened to and treated fairly if they complained. The provider had a robust process in place to enable them to respond to people and their concerns, investigate them and had taken action to address their concerns.

Staff were knowledgeable about people's needs and told us they left drinks and snacks for people where required.

Staff respected people’s cultural needs and took these into consideration when planning people’s care. Staff took practical steps to meet people’s cultural needs.

Staff told us that they seek the guidance from healthcare professionals as required. They told us they would speak with people's families and inform the management team if they had any concerns about people's health.

Staff continued to have access to an ‘out of hours’ support that they could contact during evenings and weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.

The management team and staff were committed to the values and vision of the organisation and they took these into account when delivering care and support.

Further information is in the detailed findings below.