Maidstone Home Care Limited

Updated 31 May 2022

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 one 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. They had experience of caring for older people.

Service and service type

Maidstone Home Care is a domiciliary care agency which provides care and support for people in their own homes. Care is provided for a range of people including older people and people at the end of their lives. The service operates in areas of West Kent.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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.

Inspection activity started on 14 April 2022 and ended on 26 April 2022. We visited the location’s office/service on 21 April 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 five people who used the service about their experience of the care provided and five relatives. We spoke with five members of staff including the registered manager who was also the nominated individual, the operations manager and three care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included four people’s care records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted two social care professionals who were involved with the service.

Updated 31 May 2022

About the service

Maidstone Home Care Limited is a domiciliary care agency. It provides personal care for people living in their own homes. At the time of inspection, the service was supporting 20 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 and eating. Where they do we also consider any wider social care provided

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

People were not always protected from harm. The provider had not always understood their responsibilities to report concerns through safeguarding processes. Appropriate professionals (Kent County Council who consider safeguarding concerns) were not made aware of a concern and this resulted in a potential delay to actions to support a person. The registered manager and staff had not ensured they had safeguarding training which would have supported them to understand their responsibility to share concerns appropriately in a timely manner.

Care plans did not always contain detailed information about people’s health conditions and this increased the potential risk of harm. Where risks had been identified, these had not always been considered within care or risk planning processes. We did not find evidence that people had experienced harm. Incidents had not always been managed in accordance with safeguarding practice and CQC had not always been notified of concerns. Following the inspection, the provider notified CQC retrospectively of concerns.

People and relatives spoke highly of the support managers and staff provided. One person said, “They are excellent, marvellous, they can’t do enough for you”. A relative told us how the registered manager had contacted them to discuss providing additional support to manage a health concern. They said, “[The registered manager] rang to say [person] was confused due to an infection and suggested they do an extra call at lunch time to make sure [person] takes their antibiotics until [they] get better”.

Staff were consistently positive about the registered manager and how they received support through working alongside managers, telephone calls and messages. Staff did not always receive sufficient training and supervision was generally informal. Following our inspection, the provider told us they had implemented a new training programme to ensure staff received sufficient training.

Systems and processes did not effectively identify or manage concerns found with care planning, safeguarding or staff training and this is an area in need of improvement. The service did not always have robust arrangements for managing confidential information to ensure it was secure and shared appropriately in line with data security standards. Following the inspection, the provider responded promptly to review their systems to ensure they were able to demonstrate improvements were being made. People, relatives and staff spoke positively about the registered manager.

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 08 March 2019)

Why we inspected

The inspection was prompted in part due to concerns received in relation to safeguarding people from abuse. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Maidstone Home Care Limited on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safeguarding and governance of the service at this inspection.

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.