Background to this inspection
Updated
25 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of three inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave a short period of notice for the inspection to ensure that people would be available to meet with inspectors at their home. Inspection activity started on 14 November 2019. One inspector visited the office location on 14 November 2019, two inspectors visited people in their home.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and two relatives about their experience of the care provided. We spoke with eleven members of staff including the registered manager.
We reviewed a range of records. This included nine people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records relating to medication. We spoke with two health care professionals who regularly visit the service.
Updated
25 January 2020
Affinity Trust Domiciliary Care Agency West Kent provides care and support to people living in shared houses and individual flats called ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The service supported 28 people living with learning and physical disabilities living in 15 locations across Kent.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People continued to receive a personalised service. Staff knew people well and care plans were comprehensive and detailed to guide staff in how to provide care in the way people preferred. People were leading full and active lives and were supported to express their views and to be involved in decisions and choices about their care.
Staff understood their responsibilities for safeguarding people from abuse. Alerts had been raised and investigated appropriately. Risks to people were assessed and managed. People were supported to take positive risks and were encouraged to remain as independent as possible. There were enough suitable staff to care for people safely. People were receiving their medicines in line with their prescription. Incidents and accidents were recorded and monitored to ensure that lessons were learned when things went wrong.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff received the training and support they needed to be effective in their roles. New staff received a comprehensive induction. One new staff member described how this had helped them to feel confident in their new role. Staff described good communication and effective team work. Support from health care professionals was sought when needed and people were supported to have enough to eat and drink and to maintain a healthy diet.
People were supported and encouraged to express their views and to make decisions about their care and support. Information was provided to people in accessible formats depending upon their needs. Staff respected people and treated them with dignity and respect. Staff spoke with affection about the people they were caring for and knew people well. People were treated with kindness and staff promoted and supported their independence.
Complaints and concerns were recorded and responded to appropriately. People were supported to maintain relationships that were important to them. Care was responsive to people’s needs and preferences. People were supported to plan for end of life care.
The service was well led, there were effective systems in place to provide governance and oversight. Lessons were learned when things went wrong, changes were made to improve standards of care. There was a strong emphasis on engagement with people, their relatives and staff. It was evident that staff had developed positive links within the local community and that staff worked in partnership with other agencies.
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 2 November 2018).
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.