Archived: Kent Care at Home Service

The last inspection took place in February 2014 and the service was meeting all areas inspected.

Kent Care At Home is part of the Leonard Cheshire Disability charity. It provides care and support services in the Maidstone, Bromley and Sevenoaks areas to help people live independently in their own homes. Service provision is for adults of all ages with differing needs including older people, people with disabilities, learning disabilities and mental health needs.

The service had a registered manager in place. 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 did not always receive their medicines safely. The service did not have robust systems in place to ensure people received their medicine in line with good practice. People’s medicine administration recording sheets [MARS] were not completed correctly. One person did not receive their medicine as prescribed. Auditing processes did not highlight the errors we identified on the MARS.

People did not always receive care and support from familiar staff. The service had sufficient numbers of staff available to meet people’s needs. The service advertised for staff and had recruitment plans in place to ensure there were sufficient numbers of staff. The service carried out the necessary pre-employment checks to ensure suitable staff were employed. Staff received a comprehensive induction that set out their roles and responsibilities. Staff received on-going support through shadowing experienced staff and developing work based competencies.

People were protected against the risk of harm and abuse. Staff were aware of the different signs of abuse and the appropriate procedure for reporting suspected abuse. The service had clear policies on safeguarding which gave staff guidance on how to raise their concerns around abuse and harm.

People were protected against identified risks. The service had robust systems in place that identified risks and gave staff guidance on action to take to minimise them. Risk assessments were comprehensive and reviewed regularly to reflect people’s changing needs.

People received care and support from staff that underwent on-going training and reflected on their working practices. Staff received mandatory training in safeguarding, the Mental Capacity Act 2005 (MCA), the Deprivation of Liberty Safeguards (DoLS), moving and handling and medicines. Staff received supervisions and appraisals from senior staff, to reflect on their working practices, receive support and guidance and set achievable goals for the following three months.

People were not deprived of their liberty unlawfully. Staff and the registered manager were aware of their role and responsibilities in providing support to people within the principles of the MCA and DoLS.

Consent to care and treatment was sought prior to care being delivered. People were encouraged to make choices about their care and had their choices respected. People’s care plans were person centred and tailored to people’s needs. Care plans were reviewed regularly and updated to reflect people’s changing needs.

People were provided with sufficient amounts to eat and drink that met their health and nutritional needs, if agreed in their care package. Staff ensured people were able to access food and drink that met their preferences. People were encouraged to participate in community based activities, if agreed in their care package.

People had access to health care professionals when needed. Staff supported people to access community based health care services and guidance given was recorded in their care plans. The registered manager actively encouraged partnership working.

People were aware of the process for raising concerns and complaints. The service had procedures in place to manage people’s concerns in a timely manner. The service had not received any complaints in the last 12 months.

The registered manager had systems and processes in place that monitored the quality of the service and sought feedback on the provision of care provided. The registered manager informed the Care Quality Commission of notifiable incidents, which occurred at the service.

We also spoke with three people using the service and four carers/relatives. People and their representatives expressed satisfaction with their care and support packages. One person told us, "Staff are all professional, friendly and caring. I look forward to their visits'. Another stated, 'I feel in control of my care and how staff do things, they are flexible and listen to what I want them to do'. Records showed that people's needs had been assessed and were being met in ways that ensured their safety and wellbeing.

We looked at three files of people supported to take medication. We found that people were protected against risks associated with medicines because appropriate arrangements were in place. Whilst staff had not followed the agency's procedure for recording medication support, this had been recorded. We saw that staff had received a comprehensive induction and training relevant to their roles. They told us that communication systems worked well and that they felt supported by management and supervision arrangements. Quality assurance systems were effective. Information about people's experiences had been sought and used to monitor risks and the quality of service provision. Emergency procedures were in place.

People we spoke with told us that they were involved in making decisions about their care and found the service supportive in ensuring that they understood what care could be provided.

People told us that they had experienced late or missed calls, but that the service 'Had got better'. People we spoke with told us that they now received a call from the carer or the office if the carer is running late or cannot attend.

Staff told us that they felt well supported and received good training, regular supervision and performance appraisals.