We Care SW Ltd

People, relatives, staff and an external trainer spoke highly of Kinder Care and Support. The service had strong person-centred values and placed people at the heart of their work. People had access to a stable staff team they knew well and achieved positive outcomes and strong relationships.

People were fully involved in their care and their wishes respected. One person said, “I can’t tell you how amazing Kinder Care are. They really are top class and I have used other agencies.” People’s views were sought and their consent was always gained before any care took place. People were offered as many choices as possible and people and families could access their care plans at any time.

People’s care plans contained personalised information which detailed how they wanted their care to be delivered. Staff knew people well and expressed care and affection for them when speaking with us.

Staff were valued and supported by the provider and manager. All staff we spoke with were proud to work for the service and praised the high standards of care expected. Staff comments included, “We know people well. I really love coming to work and seeing people every day.”

Risks to people’s health, safety and wellbeing were assessed and management plans were put in place to ensure these were reduced as much as possible.

People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

There was good leadership at the service and people, relatives and staff spoke highly of the provider and manager. There was a positive culture and staff felt their voices were listened to.

People were supported by kind and caring staff who worked hard to promote their independence and sense of wellbeing.

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.

Staff were provided with the training, supervision and support they needed to care for people well.

The provider and manager were passionate about improving the service and had plans for future projects to benefit people. They had worked hard to address the issues raised in the previous inspection. There were new and robust quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided. These were embedded and working well.

The manager and their team were committed to delivering high quality and safe care to people and involving them in the planning of their care and the running of the service.

More information is in the full report.

Rating at last inspection: This service was last inspected on 7 March 2018 where it was rated requires improvement overall. The areas of safe, effective, responsive and well led required improvement. During this inspection in 2019 we found these areas had been fully addressed and the service had improved to good.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Not everyone using Kinder Care and Support Ltd received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 73 people receiving personal care.

The inspection was announced and took place on 05, 06 and 07 March 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. It also allowed us to arrange to visit people receiving a service in their own homes.

There was a manager in post who was in the process of applying as a registered manager with the Care Quality Commission. 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 2008 and associated Regulations about how the service is run. The service was a small family run business and the provider was supported by a manager and deputy manager, team leaders, care workers and care co-ordinators in the office.

The management team were committed to improvement to ensure they provided a good quality service to people. Although they were experienced in care there were some areas which required improvement including the quality assurance and leadership oversight of the service, to ensure standards were maintained with a robust system. The manager and deputy manager were keen to learn and improve systems to ensure people remained safe.

Staff provided good care but they were not always supported by consistent, relevant training or consistent care records, medicine administration information and risk assessments that clearly informed them about how to meet people’s individual needs. Most staff had received safeguarding training, four had not, although all staff we spoke to were knowledgeable about when and who to contact if they suspected anyone was at risk of abuse. The daily records showed that people were receiving person centred care in the way people preferred but this often involved people having to tell staff what to do if they had not visited before. People were happy with the care they received. For example, “On the whole, I am pleased with the carers and usually have the same two every week whom I find to be excellent as are the managers.” However, not all staff were competent to use manual handling equipment such as stand aids.

Care workers said they enjoyed working for the service. They were well motivated and committed to providing a service that was personalised to each individual. People were fully involved in the initial assessment before receiving care, but care planning itself was inconsistent and a care plan was not always discussed with people or formulated. Some people had no Kinder Care and Support Ltd care plan, other than the initial social services ‘My Plan’ or it lacked full information. This put people at risk of not receiving the care they needed, however despite this, we did not see any negative outcomes to people’s care, during our inspection.

There were quality assurance systems and audits but these were inconsistent relating to staff training and induction and care plan reviews. They had not identified all the areas which required improvement, found as a result of our inspection. There was no overview of staff training needs but the manager knew that training had been lacking in the past and had already booked a new training company for the near future.

There had been few complaints which had been made to the service and all telephone calls to the office were documented. However, communication could be more robust as actions taken were recorded in different places, written or on the computer system, or not marked as actions taken. This meant there was a risk communication may not be shared, some people said they were not always sure their calls had been communicated robustly, although we did not see any examples of this. People and staff felt listened to and said they could speak with a member of the management team or any staff, at any time.

People received effective care which met their individual needs and preferences. People told us the service was flexible and made adjustments to accommodate their wishes and changing needs. For example, when people had health appointments or had a health need or additional shopping requests. Where any concerns were raised about a person's health or well-being prompt action was taken to make sure they received the support and treatment needed, although actions were often not easily accessible as they were recorded within the daily records. Staff, were pro-active in recognising areas of improvement for people, suggesting and advocating for people, contacting health professionals who could further help promote people’s independence.

People told us they appreciated the visits from staff who, were always cheerful and treated them with respect. Staff were knowledgeable about how to identify and manage any potential safeguarding issues. People received a weekly rota stating which carer would be visiting. Some people said they did not always know the carer who came. The manager said this tended to only occur if staff were sick, but told us they would now ensure they would phone people to let them know if a carer they may not have met before would be visiting, that day.

People were complimentary about the care workers who supported them. People we spoke with and visited were very positive about the caring nature and reliability of staff, who visited and stayed the correct amount of time. There had been no missed visits, and during the snowy weather care had been taken to prioritise visits, and phone calls had been made to each person to ensure they were fine, and/or to determine if family could assist that day. The office computer system alerted office staff to any late calls as care workers were required to log in on visit arrival and departure times.

There were sufficient numbers of staff employed, who had been recruited safely, to ensure people received their care and support at times of their choosing. People’s comments included, “They are just extremely pleasant, confident people”, “I find them very good”, “What’s good is that they are very flexible, which is important” and “They are very kind. They don’t rush you, which is good. They always ask if there’s anything else they can do.”

There was a robust recruitment process to ensure people were protected and cared for by staff suitable to work with vulnerable people. Despite the lack of current robust training, staff competency was monitored through regular spot checks, and supervision sessions. Staff managed infection control well and used personal protection equipment (PPE), such as gloves and aprons, to minimise risk of cross contamination for people.

We found three breaches of our regulations.

You can see what action we told the provider to take at the back of the full version of the report.