Background to this inspection
Updated
24 June 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 11 May 2023 and ended on 19 May 2023. We visited the location’s office on 11 May 2023.
What we did before the inspection
We reviewed information we had received from the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 12 people and a relative about their experience of the care provided. We spoke with 9 staff, including care staff, co-ordinators, the registered manager, and the head of community operations. We reviewed a range of records. This included 5 people’s care records and associated risk assessments and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies, audits and training records were also reviewed.
Updated
24 June 2023
About the service
Care at Home Services (South East) Ltd - Canterbury, Herne Bay & Whitstable is a domiciliary care agency providing provides care and support to a wide range of people including, older people, people living with dementia, and people with physical disabilities. At the time of our inspection there were 101 people using the service.
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 and what we found
Checks and audits to monitor the quality and safety of the service provided were not consistently robust. Whilst surveys were used to monitor the quality of service, the results had not always been analysed and provided to the registered manager by head office.
Risks to people’s health, safety and welfare and care plans were not consistently detailed. Medicines recording was not consistently accurate. For example, body maps, for prescribed creams, were not used in line with best practice.
People were protected from the risks of abuse by staff who understood how to recognise signs and where to report concerns to. People were protected from the risks of infections by staff who followed safe infection control practices.
People were supported by a regular staff team who knew people well. People and relatives told us staff generally arrived on time and stayed the correct length of time. Staff had been recruited safely.
People felt the service they received was good and told us they felt involved in the planning and management of their care and support. People told us the staff were kind and caring and respected their privacy.
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
The last rating for this service was good (published 1 January 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care at Home Services (South East) Ltd - Canterbury, Herne Bay & Whitstable on our website at www.cqc.org.uk.
Enforcement
At this inspection we have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report. We have identified a breach in relation to good governance at this inspection.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.