The inspection was carried out on 13 May 2015, and was an announced inspection. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us.
KD Care is a domiciliary care agency which provides personal care and support for people living in their own homes. The agency provides ‘live-in’ carers, twenty-four hours per day, either for long term care, or for respite care. The agency office is based in Bobbing, near Sittingbourne and is easily accessible for staff and visitors. The provider has ensured that the agency office is accessible to people who may have a mobility disability. At the time of the inspection the service was providing support to seven people, two of whom used the agency services for regular respite care. Most people were privately funded, occasionally people were funded by the local authority or through NHS continuing care services.
The service is run by the provider who is also the registered manager of 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 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice.
The agency had suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the agency’s whistleblowing policy. They were confident that they could raise any matters of concern with the registered manager, or the local authority safeguarding team. Staff were trained in how to respond in an emergency (such as a fire, or if the person collapsed) to protect people from harm.
The agency provided sufficient numbers of staff to meet people’s needs and provided a flexible service. The agency had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. Refresher training was provided at regular intervals.
All staff received induction training which included essential subjects such as maintaining confidentiality, moving and handling, safeguarding adults and infection control. They worked alongside experienced staff and had their competency assessed before they were allowed to work on their own.
The provider carried out risk assessments when they visited people for the first time. Other assessments identified people’s specific health and care needs, their mental health needs, medicines management, and any equipment needed.
Incidents and accidents were recorded and checked by the provider to see what steps could be taken to prevent these happening again. The risk in the service was assessed and the steps to be taken to minimise them were understood by staff.
The provider involved people in planning their care by assessing their needs on the first visit to the person, and then by asking people if they were happy with the care they received.
Staff had been trained to administer medicines safely. They followed an up to date medicines policy issued by the provider and they were checked against this by the manager.
People were supported with meal planning, preparation and eating and drinking. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.
People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. The provider carried out spot checks to assess care staff’s work and procedures, with people’s prior agreement. This enabled people to get to know the provider.
The agency had processes in place to monitor the delivery of the service. As well as talking to the provider at spot checks, people could phone the office at any time. People’s views were also obtained through annual surveys. These could be completed anonymously if people wished. The provider analysed these and checked how well people felt the agency was meeting their need.