18 September 2014
During an inspection in response to concerns
We carried out this inspection in response to concerns that one or more of these key areas were not being met.
Our aim is to contact a representative proportion of people who use the service and/or their relatives. The inspector visited the service, looked at records, talked with staff, telephoned three people who used the service or their relatives and received questionnaires from seven people who used the service or their relatives.
Is the service safe?
People told us that they were treated with dignity and respect by staff. Most people told us that they felt safe.
Recruitment practices were safe and ensured that appropriate checks were carried out before staff worked independently in the community.
Is the service effective?
People and relatives said that they had been involved in writing plans of care and that they reflected people's current needs.
Staff had a good understanding of the people's care and support needs and knew people well. In the agency's survey of people who used the service, in May 2014, most people rated staff attitude as good or very good.
Staff received ongoing training to ensure that they had the skills and experience to support the people in their care.
Is the service caring?
Most people were complimentary about their regular care staff. Comments included, 'Staff are very friendly and make Mum feel at ease'; and 'The care workers address my relative by name and talk her through what they are doing. They are very understanding of her dementia and her varying moods'. However, some people told us that there were occasions when staff were rushed and one person told us that staff did not meet their needs. This person told us, 'If staff can walk out twice in one week there is not a lot of care there '.
Is the service responsive?
People's needs had been assessed before they used the service. Assessments were comprehensive and included information about people's health, social and personal care needs.
People were not satisfied with the way that their care was delivered as there were issues with the time keeping of care staff. They did not always arrive at expected times, or carry out all the tasks expected of them. For example, one person with diabetes did not receive their meals at set times, as was required. People also did not always know which member of staff would be supporting them, which they said was upsetting.
People knew how to make a complaint if they were unhappy. Complaint records showed that people's complaints had been investigated and resolved to their satisfaction.
We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to meeting people's care and welfare needs.
Is the service well led?
People using the service had completed an annual satisfaction survey. A summary had not been made of the survey, so it could not be assured that action had been taken to address any shortfalls or concerns identified. Comments included, The majority of the ladies are really wonderful and I have the greatest admiration for all they do'; 'Intimate care is carried out very well'; and 'Not sure which carer to expect'.
The agency was behind in its programme of undertaking supervisions, spot checks and appraisals. This meant that the agency were not aware of shortfalls in staff competence, such as how to use an overhead hoist. Staff who had transferred from a domiciliary care agency, to work at Beech Tree Total Care Ashford had not received a full induction, nor had all of them had their competency assessed by Beech Tree Total Care Ashford, to ensure that they were working to the expected standard.