Care With Kindness Limited

Updated 16 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 1 inspector and an Expert by Experience made telephone calls to people’s relatives. 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 houses and flats.

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

We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service including the information obtained during a recent CQC direct monitoring activity call and 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

Inspection activity started on 5 May 2023 and ended on 18 May 2023.

We visited the location's office on 9 and 11 May 2023. We reviewed a range of records. This included policies and procedures, 4 staff files, 5 people's care plans and records, medication records, training data and quality assurance records. We spoke to 5 staff including the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also visited 3 people who use the service.

Following the site visit, we communicated with a further person who uses the service, and 2 relatives. We sought feedback from 10 professionals with 5 responses received. An expert by experience also spoke with 1 person and 6 family members about their experience of the care provided.

Updated 16 June 2023

About the service

Care with Kindness Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection they were providing a personal care service to 16 people.

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. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People had care plans in place, however, these did not include clear information to guide staff to provide care and support. Not all risks had been assessed and some individual risks to people were not thoroughly assessed and mitigated. Although staff in general knew how to support people safely, they did not always have detailed guidance to ensure people received safe care at all times. We did not find that this had a negative impact on the care people received, but we have identified these as areas of practice that need to improve.

Recruitment procedures were not always robust, and improvements were needed to ensure staff received training and appropriate assessments of their competence to fulfil their role.

Medicines were not always managed safely, and best practice guidance was not always being followed in relation to a clinical task delegated by a health professional.

Staff understood how to protect people from poor care and abuse. Some staff had not received training in safeguarding vulnerable adults.

Quality assurance systems were not fully effective and did not address the shortfalls we found during our inspection. We found no evidence that people were harmed but these shortfalls put them at increased risk. We discussed these concerns with the nominated individual and registered manager who were responsive to feedback and started making changes to improve the service.

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 support people received was person centred. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. People told us they received care by staff who were “Courteous and polite” and “Kind and compassionate.”

Throughout the inspection we observed staff interacting with people in a caring and considerate way. People and relatives were complimentary about the care and support they received and spoke positively about the management of 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

This service was registered with us on 31 March 2022 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

Enforcement and Recommendations

We have identified breaches in relation to risk management, staff training and support, medicines and governance at this inspection.

We have also made recommendations in relation to recruitment and consent.

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.