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Kind Caring At Home Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 September 2018

This service is a domiciliary care agency which provides personal care and support to people in their own homes. It provides a service to older adults. Not everyone using the service receives regulated activity; 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. At the time of our visit the service supported 11 people in the Surrey area.

The inspection took place between 25 July and 6 August 2018 and was unannounced.

This service had not been inspected before. The service is in the process of registering a new manager with CQC who has applied for registration. 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.

CQC was contacted by the provider in April 2018 to discuss an action plan that had been created to address various issues that had been identified in relation to the quality of care. This was still in the process of being implemented by management and the provider at the time of the inspection.

Recruitment policies and procedures were not being adhered to, to ensure that staff were suitable to work with people. The provider was not ensuring safe and proper recording of medicine administration. There was no overview or analysis of accidents and incidents to enable staff to see patterns or trends to reduce the risk of an incident or accident re-occurring. Care plans were not always person centred or detailed.

Staff had not completed the mandatory training set out by management and had not been signed off to work independently which was contrary to the providers own policy. Staff supervisions and appraisals had not been completed. The action plan created to improve, develop and sustain the service had not been completed by management. There were no audits or quality assurance processes being completed by management except for spot checks on visits.

Staff managed risks to people’s safely. Where incidents had occurred, the staff took appropriate action to keep people safe. Staff understood how to identify and respond to suspected abuse. Staff took appropriate measures to stop the spread of infection when care was being provided. There was a business continuity plan in place for people in case of an emergency or disaster.

People were supported to prepare and eat food that they liked in line with their dietary requirements. People's needs and choices were assessed and people were involved in important decisions. Staff worked alongside healthcare professionals and other organisations to meet people's needs.

Staff treated people in a caring, considerate and respectful way. People told us that they felt staff were kind towards them. People's choices were considered in the delivery of care.

People's histories and care needs were included in their care plans which helped staff provide responsive care. People received personalised care that reflected their needs, interests and preferences. People had access to activities that reflected what was important to them. Regular reviews were undertaken and any changes to people's needs were actioned by staff. Staff communicated any changes in care with each other. The provider had a clear and accessible complaints procedure although some responses had not been recorded.

No one was receiving end of life care at the time of our inspection. Surveys and newsletters had been completed to involve people and staff in the running of the service.

During our inspection we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full

Inspection areas

Safe

Requires improvement

Updated 14 September 2018

The service was not always safe.

Robust recruitment checks were not always completed. There were sufficient staff to support people.

Shortfalls were identified in the management and support of people's medicines.

Incidents and accidents were not recorded or analysed to help keep people safe.

Risks associated with people's needs were sufficiently assessed and planned for.

Staff were aware of how to protect people from abuse and avoidable harm.

Staff followed infection control measures to prevent the risk of cross contamination.

Effective

Requires improvement

Updated 14 September 2018

The service was not always effective.

Staff had not completed the training they needed to do their jobs and did not have their competency assessed. Supervisions and appraisals had not been completed.

The principles of the Mental Capacity Act (2005) were complied with and people’s consent was always sought.

People's health was monitored and changes were shared with others where required.

People’s needs and choices were assessed and considered in their care.

People received effective support with meeting their nutritional needs.

Caring

Good

Updated 14 September 2018

The service was caring.

Staff were kind, caring and compassionate.

People were involved in their care and support.

People’s dignity, privacy and independence were promoted.

Responsive

Requires improvement

Updated 14 September 2018

The service was responsive.

Not all responses to complaints had been recorded although there was a complaints policy in place that was accessible to people.

Care plans did not always reflect people's needs and interests but people received personalised care specific to their needs. Care needs were reviewed regularly and any changes were actioned by staff.

People were supported to carry on doing activities that they enjoyed in their routines.

Well-led

Requires improvement

Updated 14 September 2018

The service was not always well led.

Monitoring and audit processes had not been completed to check the safety and quality of the service.

Where people's views were gained these were used to improve the quality of the service.

People and staff thought the manager was supportive and they could go to them with any concerns.

The culture of the service was supportive and staff felt valued and included.

The service notified CQC of significant events appropriately.