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Everycare West Kent Requires improvement

Reports


Inspection carried out on 24 November 2019

During a routine inspection

About the service

Everycare (West Kent) Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection there were 56 people using the service. This included older people, people with a physical disability, mental health need and a learning disability. Care and support was provided within and around Tunbridge, Tunbridge Wells and Sevenoaks.

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

People told us they received the care they needed, when they needed it. We found no evidence that people had been harmed. However, it could not be assured people would be given their medicines as prescribed. This was because medication administration records were not regularly checked to make sure they were accurate.

There was a lack of management oversight. Quality monitoring systems were not sufficient or robust enough to identify shortfalls and drive continuous improvement in the service.

People said they were usually supported by staff they knew and trusted, so they felt safe when receiving care. Staff knew how to recognise safeguarding concerns, and these had been appropriately reported to the local authority safeguarding team. Risks to people’s well-being had been assessed and were effectively managed.

Staff had received training and had the skills and knowledge to support people’s individual needs. People were supported to access healthcare services in partnership with their families.

Support for people enabled them to be as independent as possible so they could remain in their own home. They had 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.

People and their relatives told us staff were kind and caring. They said they were treated with dignity and respect and their independence promoted. Regular care staff knew people’s preferred routines. People told us the emotional support they received from staff was important to their overall well-being.

People said they received care and support that was responsive to their needs. They said staff supported them with the things they needed help with and asked if there was anything else they needed. People told us they did not have any complaints but knew how to complain should they need to. Complaints raised with the provider had been investigated 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 3 May 2017).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

After the inspection

We received additional feedback from staff members.

Enforcement

We have identified breaches in relation to medicines management and quality monitoring.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 31 March 2017

During a routine inspection

Everycare (West Kent) Ltd is a domiciliary care agency that provides personal care and support to people in Tunbridge Wells, Tonbridge, Sevenoaks and surrounding areas. There were 42 people using the service at the time of our inspection, five of whom lived with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant regulations.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks of falls for people.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

The administration of medicines was correctly managed and staff kept relevant records that were accurate. Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records helped staff deliver care and support that met people’s individual needs. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed.

The provider and the management team were open and transparent in their approach. They placed an emphasis on continuous improvement of the service. There was a robust system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and care.

Further information is in the detailed findings below.

Inspection carried out on 14 and 15 April 2015

During a routine inspection

The inspection was announced and was carried out on 14 and 15 April 2015 by one inspector and was supported by an expert by experience who telephoned people and relatives for their views.

Everycare (West Kent) Ltd is a domiciliary care agency providing personal care to people in their own homes in and around the Tunbridge Wells area. Some people using the service are older people including people who may live with Dementia, or with learning and/or physical disabilities.

There was a registered manager in post. 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.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns. People told us, “I felt safe from day one; It’s a relief having them around”.

Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.

There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs and travel time was taken into account to reduce lateness of visiting calls. The manager followed safe recruitment practices.

Staff were trained in the safe administration of medicines. Records relevant to the administration of medicines were monitored to ensure they were accurately kept and medicines were administered safely to people according to their needs.

Staff knew each person well and understood how to meet their support needs. People told us, “They are well aware and respectful of my specific needs”. Each person’s needs and personal preferences had been assessed before care was provided and were continually reviewed. This ensured that the staff could provide care in a way that met people’s particular needs and wishes.

Staff had completed the training they needed to care for people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions and were scheduled for an annual appraisal to ensure they were supporting people based on their needs.

All care staff and management were trained in the principles of the Mental Capacity Act 2005 (MCA) and were knowledgeable about the requirements of the legislation.

Staff sought and obtained people’s consent before they provided care. When people declined, their wishes were respected and staff reported this to the manager so that people’s refusals were recorded and monitored.

Staff provided meals when appropriate and ensured they were well balanced to promote people’s health. Staff knew about people’s dietary preferences and restrictions.

People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their care and treatment was delivered.

Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs when they had visual impairment.

People’s privacy was respected and people were assisted with their personal care needs in a way that respected their dignity.

People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of care, likes and dislikes and preferred activities. The staff promoted people’s independence and supported them during activities. They encouraged people to do as much as possible for themselves.

People’s individual assessments and care plans were reviewed regularly with their participation or their representatives’ involvement. People’s care plans were updated when their needs changed to make sure they received the care and support they needed.

The provider took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. The provider sent questionnaires regularly to people to obtain their feedback on the quality of the service. The results were analysed and action was taken in response to people’s views.

Staff told us they felt valued under the manager’s leadership. The manager notified the Care Quality Commission of any significant events that affected people or the service. Quality assurance audits were carried out to identify how the service could improve and the manager had an action plan for making the improvements.

Inspection carried out on 10 December 2013

During a routine inspection

We visited the office and spoke with the registered manager and five members of staff. We later spoke on the telephone with two people who used the service, five relatives and two health or social care professionals to gain their views.

People told us that they were able to make decisions and choices about the way their care and support was delivered. People, or their relatives, confirmed that they had given their consent to the support they received.

People�s and relatives told us they were very satisfied with the service and that staff promoted people�s health, welfare and independence. A relative told us �they give her some independence so that she is not always relying on us �and �you expect teething problems when things start, but there have been none. They have been absolutely brilliant�. Another relative told us �I have to say I have been pleasantly surprised�.

People told us that the staff were respectful, caring and confident. Their comments included �they are absolutely wonderful�, �they encourage me to do things for myself� and �it�s brilliant, it�s nice to have them in for a little chat�.

The service had effective recruitment and selection processes in place. Staff told us they like working there and felt well supported. Staff received the training they needed for their role and had opportunities for additional training and to gain qualifications.

The provider had systems in place to monitor the quality of the service provided. These included organisational and internal audits and systems for gaining the views of people and their representatives.