The inspection took place on 6 November 2017. The inspection was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the locations office to see us. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. This was the first comprehensive inspection since the agency was registered. There were eight people using the service who were receiving personal care at the time of the inspection. Pantiles Chambers, is known as SAP Care Services Ltd, and will be referred to in this report by the name people use: SAP Care. SAP Care was registered with CQC in November 2016 and had not been inspected prior to this inspection. SAP Care are a domiciliary care agency based in Tunbridge Wells who are registered to provide personal care to people living with dementia, older people and people with a physical disability.
At the time of our inspection there was a registered manager at the service. 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 were kept safe from abuse and harm and staff knew how to report suspicions around abuse. Risks were minimised through the use of effective control measures. There were sufficient numbers of staff deployed to meet people’s needs and ensure their safety. People received their medicines when they needed them from staff who had been trained and competency checked. Staff understood the best practice procedures for reducing the risk of infection and carried a bag of protective equipment such as hand gel and shoe protectors on every care call. The service uses incidents, accidents and near misses to learn from mistakes and drive improvements.
People had extensive and effective assessments prior to a service being offered. This meant that care outcomes were planned robustly and staff understood what support each person required. Staff were trained in key areas and had the skills and knowledge to carry out their roles. Competency checks of training ensured that staff members understood the training they received. People were supported to receive enough to eat and drink; staff used food and fluid charts to record intake for people at risk or malnourishment or dehydration.
The service worked in collaboration with other professionals such as district nursing and people’s GP’s to ensure care was effectively delivered. People maintained good health and had access to health and social care professionals. Environments were risk assessed to ensure people were safe in their homes and staff could work without the risk of danger. The principles of the Mental Capacity Act were being complied with and any restrictions were assessed to ensure they were lawful and the least restrictive option.
Staff treated people with kindness and compassion in their day to day care. Staff knew people’s needs well and people told us they valued and liked their care staff. People and their relatives were consulted around their care and support and their views were acted upon. People’s dignity and privacy was respected and upheld and staff encouraged people to be as independent as safely possible.
People received a person centred service that was supportive of their needs. People’s needs were fully assessed and care plans ensured that personal details were carried through to care delivery. There was a complaints policy and form, though no complaints had yet been received. Staff were open to any complaints and understood that responding to people’s concerns was a part of good care. End of life care had been planned for people who wished to do so. The service worked with local hospices to implement their own end of life care policy and ensure people had a dignified death in the manner of their choosing.
There was an open and inclusive culture that was implemented by effective leadership from the registered manager. People and staff spoke of a ‘family’ care company that was small but caring. The registered manager had ensured that audits of quality were effective in highlighting and remedying shortfalls and the registered manager understood their regulatory responsibilities. People, their families and staff members were engaged in the running of the service. There was a culture of learning from best practice and of working collaboratively with other professionals and health providers to ensure partnership working resulted in good outcomes for people.