Expertise Homecare (Central & West Kent) Ltd

Updated 23 January 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience who made telephone calls. 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

Expertise Homecare (Central & West Kent) Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Inspection activity started on 31 October 2019 and ended on 5 November 2019. We visited the registered office on both days.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was announced. We gave the service five days’ notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection. We also needed to gain people’s consent to being contacted for their feedback.

What we did before the inspection

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed the information we already held about this service, including details of its registration, previous inspection reports and any notifications of significant incidents the provider had sent us. We used all of this information to plan our inspection.

During the inspection-

We spoke with 11 people who used the service and eight relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, the ‘customer liaison supervisor’, the operation manager and three care staff.

We reviewed a range of records. This included seven people’s care plans, risk assessments, daily care records and medicines records. We looked at three staff files in relation to recruitment and staff support and supervision. We also saw a variety of records relating to the management of the agency, including a sample of audits, quality assurance surveys, accidents and policies and procedures.

After the inspection –

We received feedback from other professional agencies who are involved with the service.

Updated 23 January 2020

About the service

Expertise Homecare (Central & West Kent) Ltd is a domiciliary care service registered to provide personal care for older people, people who live with dementia, people who have learning disabilities or autistic spectrum disorder and people who have a physical disability. At the time of our inspection 65 people were receiving personal care.

Not everyone using the agency received a regulated activity; the Care Quality Commission (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.

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

People and their relatives told us they were frustrated with the lack of consistency with care staff. The registered manager had been made aware of several concerns with the interim management team whilst they were on maternity leave. The registered manager decided to return to the business early and had started to implement changes to improve the quality of care people received. Recruitment and retention processes were amended to retain staff, enabling people to receive continuity of care.

People, relatives and others had been asked for their views about the service. As a result, the feedback an action plan had been developed to improve the service people received. The registered manager had increased staff morale and the retention of new staff.

Recruitment of care staff was underway to address the shortfall. Safe recruitment practices were followed to reduce the risk of unsafe staff working with people. Staff received continuous support, supervision and guidance from their line manager. Staff were trained to meet people’s needs including their specialist needs.

People’s needs were assessed before they started using the service to make sure staff could meet their needs. Care plans were personalised to meet people’s needs. People were involved in the development and review of their care plan.

Staff worked alongside healthcare professionals to ensure people remained as healthy as possible. Guidance was available to inform staff how to meet people’s specific health needs. People's personal information was stored securely.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. People were able to make decisions about their care and support and to maintain control of their lives.

People felt safe with staff who understood the action to take if they suspected potential abuse. Potential risks posed to people had been assessed with action taken to reduce the risk. People’s safety within their home had been recorded, and referrals were made to the appropriate healthcare professionals to promote people’s safety.

Staff treated people with kindness, care and compassion. People’s likes, dislikes and personal histories were recorded within their care plan. People’s privacy and dignity was protected whilst encouraging people to be as independent as they were able to.

People’s feedback, concerns and complaints were listened to and acted on. There were a range of checks and audits in place to promote a high-quality service and continuously improve.

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 overall with Outstanding in responsive (published 23 March 2017).

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.