Kent Enablement at Home

This inspection took place on the 27 November 2017 and was announced.

Kent Enablement at Home (KEaH) is part of the Social Care, Health and Wellbeing Directorate of Kent County Council. It is the in-house provider for support at home for older people and adults with a physical disability. The service has been designed for people who need support to regain their independence after a medical or social crisis. The service provides time limited support to people in their own home, for a period of three weeks initially. The service supports people who have been discharged from hospital, or those referred from the community. Support provided includes help with day to day tasks like cooking, shopping, washing and dressing and help to maintain their health and wellbeing. At the time of our inspection there were 65 people receiving the regulated activity of personal care from the service, living in the areas of Dartford, Gravesend and Swanley. People were funded through Kent County Council Social Services.

At the last inspection in November 2015, the service was rated Good in all domains and at this inspection we found the service remained Good.

There continued to be a registered manager employed at the service. 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 registered manager was also the operations manager of the service and covered the five registered locations, providing a similar service in other areas of Kent.

People continued to receive care from staff that were caring, kind and compassionate. People we spoke with told us they were positive about the support they received from the service.

People told us they felt safe. Staff continued to receive training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any concerns raised would be fully investigated to help ensure people were protected.

There were enough suitably qualified staff available to meet people's needs. The service was flexible and responded to people's changing needs. People told us they were able to request their visits at agreed times. People we spoke with told us they had never experienced a missed care visit.

People continued to receive care from staff who had the right knowledge and skills to meet their needs. People and their relatives spoke very highly of staff and comments included, "Nothing is too much trouble", "There is nothing to complain about", "They are kind and caring", "Staff are nice and helpful" and "Always willing to do what they can."

People’s needs were assessed and their care was planned to maintain their safety, health and wellbeing.

Risks were assessed and recorded by staff to protect people. There were systems in place to monitor incidents and accidents.

Staff were aware of people's preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. Staff treated people with dignity and respect.

We spoke with people who used the service and they told us the support workers always asked for their consent prior to completing care tasks. Staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

People continued to be supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff told us there was good communication with the management of the service. Staff said management were "Fantastic" and "Very supportive."

Procedures for reporting safeguarding concerns were in place. The registered manager knew how and when they should escalate concerns following the local authorities safeguarding protocols.

The provider had processes in place to monitor the delivery of the service. People’s views were obtained through surveys, one-to-one meetings, meetings with people’s families and social workers.

Staff continued to have good levels of support and supervision to enable them to carry out their roles.

Staff continued to be recruited safely through a robust recruitment and selection process in place. This enabled the provider to select staff that were suitable to work with people. Staff received an induction which included mandatory training and shadowing experienced staff.

The registered provider had a system in place to ensure people received their medicines as prescribed. Staff continued to receive training to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

There were policies in place which ensured people would be listened to and treated fairly if they complained. The provider had a robust process in place to enable them to respond to people and their concerns, investigate them and had taken action to address their concerns.

Staff were knowledgeable about people's needs and told us they left drinks and snacks for people where required.

Staff respected people’s cultural needs and took these into consideration when planning people’s care. Staff took practical steps to meet people’s cultural needs.

Staff told us that they seek the guidance from healthcare professionals as required. They told us they would speak with people's families and inform the management team if they had any concerns about people's health.

Staff continued to have access to an ‘out of hours’ support that they could contact during evenings and weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.

The management team and staff were committed to the values and vision of the organisation and they took these into account when delivering care and support.

Further information is in the detailed findings below.

Kent Enablement at Home (KEaH) is part of the Social Care, Health and Wellbeing Directorate of Kent County Council. It is the in-house provider for support at home for older people and adults with a physical disability. The service has been designed for people who need support to regain their independence after a medical or social crisis. The service provides time limited support to people in their own home, for a period of three weeks initially. The service supports people who have been discharged from hospital, or those referred from the community. Support provided includes help with day to day tasks like cooking, shopping, washing and dressing and help to maintain their health and wellbeing. There were 90 people using the service at the time of our inspection, living in the areas of Dartford, Gravesend and Swanley. People were funded through Kent County Council Social Services.

There was a registered manager employed at the service. He was also the operations manager of the service and covered the five registered locations, providing a similar service in other areas of Kent. 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 registered manager and staff had received training about the Mental Capacity Act 2005 and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care.

Staff had received training about protecting people from abuse and showed a good understanding of what their responsibilities were in preventing abuse. They were confident that they could raise any matters of concern with the registered manager, or the local authority safeguarding team.

The service provided sufficient numbers of staff to meet people’s needs and provide a flexible service. The service had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. All staff received induction training which included essential subjects such as maintaining confidentiality, moving and handling, safeguarding adults and infection control. They worked alongside experienced staff and had their competency assessed before they were allowed to work on their own. Refresher training was provided at regular intervals. Staff had been trained to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

Working in community settings staff often had to work on their own, but they were provided with good support and an ‘Outside Office Hours’ number to call during evenings and at weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue. For example, when there was heavy snow or if there was a power failure at the main office.

People’s needs were assessed and care and support was planned to maintain people’s safety, health and well-being. Risks were assessed by staff to protect people. People told us that staff discussed their care with them so that they could decide how it would be delivered. Care plans were kept reviewed and updated.

People spoke about the staff in a positive light regarding their feelings of being safe and well cared for. They thought that staff were caring and compassionate.

There were policies in place which ensured people would be listened to and treated fairly if they complained. The registered manager ensured that people’s care met their most up to date needs and any issues raised were dealt with to people’s satisfaction.

People were happy with the leadership and approachability of the service’s registered manager. Staff felt well supported by registered managers. Audits were effective and risks were monitored by manager to keep people safe. There were systems in place to monitor incidents and accidents.

We saw staff were trained to support people who used the service in order to achieve agreed goals. People told us the staff 'encouraged' them to do what they could for themselves in order to become independent again. One person told us they "all let me do what I wanted and could manage myself." The individual's goals and the support to achieve them were recorded and kept under review.

People who used the service told us the support was provided in a way which protected their privacy and dignity and one person said "everyone who came was respectful."

Staff told us they received 'good training' which included induction training prior to starting work. New staff worked alongside experienced colleagues before working alone. They told us they were 'well supported' by their managers.

People who used the service told us they had the opportunity to feedback their experiences. The quality of the service delivery was monitored for effectiveness in enabling people to regain their independence.

Those people we spoke with who used the service told us they knew how to complain although all said they had not had cause to do so. We saw they had a written procedure provided within their pack of information about the service.