We carried out a review of the data available to us about J & K Care Specialists 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 J & K Care Specialists, you can give feedback on this service.
J and K Care Specialists is a domiciliary care agency providing personal care to 44 people living in their own homes. People had a range of needs, these ranged from older people to people living with a learning disability. Not everyone who used the service received personal care. The Care Quality Commission (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
Since our last inspection, the provider had made improvements to their systems around auditing people’s care and medicines records. The registered manager had a good understanding of their role and people told us they were competent and approachable.
People received good quality care, that was focussed on their specific needs and preferences. Care was consistently delivered by staff who understood people’s needs and who had undergone appropriate training in their role.
People were treated with dignity, respect and were involved in the planning and reviewing of their care.
People’s needs in relation to healthcare, nutrition and medicines were identified in their care plans. The provider worked with other stakeholders when required to help deliver effective care.
People were protected from the risks of suffering abuse and harm. Risks associated with the delivery of care were assessed and reduced.
There were appropriate systems in place to gain people’s consent to care. 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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 28 January 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
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.
J and K Care Specialists is a domiciliary care agency. It is registered to provide personal care and support for people in their own homes in the county of Hampshire. At the time of our inspection J and K Care Specialists were supporting 110 people with personal care.
The did not have a registered manager. A registered manager is a person who has registered with the CQC 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 service had a manager who had begin the registration application process with us. They were waiting for their application to be approved.
The provider’s systems for safely managing medicines were not always effective. Audits of medicines administrations records (MARs) were not always effective in identifying errors or omissions. Staff recorded missed doses of medicines but reasons for these were not always documented. Handwritten MARs were not always clear or legible. Records of discussions with people’s GPs were not available when they had not taken a medicine for periods of up to 23 days.
The provider’s systems for monitoring quality and safety within the service were not always effective. Audits of MARs were inaccurate and incomplete as they failed to identify omissions and errors.
The provider had suitable arrangements in place to protect people from avoidable harm and abuse. Staff we spoke with were clear about their responsibilities and had received the required safeguarding training. Sufficient numbers of staff were deployed to support people's needs and maintain their safety. Safe recruitment processes ensured the provider only employed staff who were suitable to work in a care setting. Risks to people were assessed and recorded in their care plans. Records showed that these were managed safely.
The provider had an infection control policy in place and people were protected from the risk of acquiring an infection. The registered manager recorded accidents and incidents and supported staff to reflect on these to prevent recurrences.
People’s needs and choices were thoroughly assessed in line with evidence based practice to support them to live as independently as possible.
People received care from suitably skilled staff who had received regular training and supervision to help develop their knowledge.
The provider complied with the requirements of the Mental Capacity Act 2005. Staff were confidently able to describe how they would apply its principles when caring for people.
People were supported to maintain a balanced diet. People were supported to access care from relevant health and social care professionals. Staff had developed respectful, caring relationships with the people they supported. Staff encouraged people to express themselves and promoted their independence, privacy and dignity.
Care plans were individualised and were written in partnership with people and their families where appropriate. These were regularly updated. Complaints and concerns were responded to promptly and investigated thoroughly.
The provider had systems in place for monitoring the quality and safety in the service. These were not always effective in identifying omissions and errors. Actions were captured in the Service Improvement Plan (SIP) which included dates for completion.
Staff worked effectively in partnership with health and social care professionals to meet people's needs
We identified one breach of the regulations. You can see what action we told the provider to take at the end of the full version of this report.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they were supported by staff they could trust, who made them feel safe. Relatives told us they had no concerns for the safety of their family member because there was good continuity and consistency of care from staff who were committed to the people they supported.
People were protected from abuse because staff were trained and understood the actions required to keep people safe. There had been three incidents since our last inspection, which had been referred to the local safeguarding authority. These incidents had been reported, recorded and investigated in accordance with the provider’s safeguarding policies and local authority guidance. People had been safeguarded against the risk of abuse by staff who took prompt action if they suspected people were at risk of harm.
Risks associated with people’s care and support needs were identified and managed safely to protect them from harm. We observed staff support people safely in accordance with their risk assessments and support plans. Risks affecting people’s health and welfare were understood and managed safely by staff.
Daily staffing needs were analysed by the registered manager to ensure there were always sufficient numbers of staff with the necessary experience and skills to support people safely. Staff told us there were always enough staff to provide the required support, which we observed in practice. Resilience to cover unforeseen absence was provided by office staff who had all completed the provider’s required training and regular bank staff.
Staff had undergone robust pre-employment checks as part of their recruitment. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider.
People received their medicines safely, administered by staff who had completed safe management of medicines training and had their competency assessed by the registered manager.
The provider supported staff to meet people’s needs with an effective programme of induction, supervision and appraisal. The provider’s required staff training was up to date and refreshed regularly to ensure staff had retained and updated the skills and knowledge required to support people effectively.
People were supported to make their own decisions and choices. Staff supported people to identify their individual wishes and needs by using their individual and unique methods of communication. People’s human rights were protected by staff who demonstrated clear understanding of guidance and legislation relating to consent and mental capacity.
People were supported to maintain a healthy balanced diet by staff who understood their dietary preferences. We observed people supported appropriately to ensure they received sufficient to eat and drink.
Staff recognised when people were unwell or upset, and took prompt action to promote their health and wellbeing. The registered manager had ensured people were referred to relevant health professionals where required. The service worked effectively with a range of health care professionals to ensure people’s health care needs were met.
Staff had developed trusting relationships with people and spoke with insight about peoples’ needs and the challenges they faced. They were able to tell us about the personal histories and preferences of each person they supported. Staff understood people’s care plans and the events that had informed them.
During home visits we observed relationships between people and staff, which were warm and caring. People and staff had two way conversations about topics of general interest that did not just focus on the person’s support needs. We observed staff had time to spend with people and always spoke with them in an inclusive manner, enquiring about their welfare and feelings. People were supported by thoughtful staff who treated them with dignity and respect.
People were involved in developing their care and support plans, which were personalised and detailed their daily routines. The registered manager was committed to ensuring people were involved as much as they were able to be in the planning of their own care.
People told us how they had been supported to access their local community, which was confirmed by staff and records. There was guidance for staff about how to support people to promote their independence and maximise the opportunity to do things of their choice.
People’s needs were assessed and regularly reviewed to ensure their care and support was responsive to changes identified. Support plans and regular reviews documented the support and care people required, and how this should be provided in accordance with their wishes. Records accurately reflected people’s needs and were up to date. Staff were provided with necessary information and guidance to meet people’s needs. People’s and staff records were stored securely, protecting their confidential information from unauthorised persons.
The service was well led. The senior staff provided clear and direct leadership and effectively operated systems to assure the quality of the service and drive improvements. Feedback from people, their relatives, and staff was sought to identify changes required to improve the quality of care people experienced. The provider’s audits were used to review changes implemented, and ensure all required actions had been taken.
People told us that they were happy with the care and support they received. One person said "I am very happy with my care, I am involved with everything." All the people with spoke with said they had no complaints.
There were appropriate arrangements in place to assist people with their medication.
The provider had an effective recruitment and selection process. Appropriate checks were made on staff before they began work.
There were effective processes in place to assess and monitor the quality of the service that people receive.
People we spoke with told us their care plans were accurate and were reviewed regularly. They said that staff arrived on time and always stayed for the right amount of time.
The staff we spoke with demonstrated a good understanding of peoples support needs while respecting their privacy and dignity. They were aware of their responsibilities in keeping people safe and reporting any suspected abuse.
Staff told us they felt supported and involved in how the service was provided. The provider asked for the opinions of people who used the service and the staff. Where appropriate they made changes to improve the service provided.