Chameleon Care (Dartford)

Updated 14 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection, which took place on 30 January 2018 and was announced. The provider was given short notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office.

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 similar services. The inspection site visit activity started and ended on 30 January 2018. It included visiting the office location to see the registered manager and staff; to review care records and policies and procedures. We also visited one person in their own home.

Prior to the inspection, we looked at previous inspection reports and notifications about important events that had taken place at the service. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.

During this inspection, we spoke with four people using the service and five relatives to gain their views about the service. We spoke with six members of staff. They included the registered manager, one manager, two senior support workers and two support workers. We also requested feedback from a range of healthcare professionals involved in the service. These included professionals from the local authority. We received positive feedback from one external healthcare professional.

We reviewed the care records of ten people that used the service, which included their care plans, health and medication records, risk assessments and daily care records. We also looked at the recruitment records for seven members of staff to see how the provider operated their recruitment procedures.

Other records we saw related to the management of the service and included staff rotas, training and supervision records, meeting minutes, quality audits and service user feedback. We also viewed the safeguarding, recruitment, equality and diversity, infection control, medicines, complaints and service users’ right’s policies.

Updated 14 March 2018

This comprehensive inspection took place on the 30 January 2018 and was announced.

Chameleon Care Dartford is a domiciliary care agency, providing personal care services to people living in their own homes. This included older and younger adults and people with complex health needs such as epilepsy, diabetes, dementia and physical disabilities.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. At the time of the inspection, there were 37 people receiving the regulated activity of personal care from the service.

At our last inspection, the service was rated Good. At this inspection we found the service remained Good.

There continued to be a registered manager in post. 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 supported by a manager who was based at the location and was responsible for overseeing the day to day management of the service.

People were continued to be protected from abuse and neglect. There continued to be appropriate systems in place to safeguard people from the risk of preventable harm. Risks to people and staff were appropriately assessed, mitigated and recorded.

Staff understood their responsibilities around safeguarding people from abuse and protecting their rights.

There continued to be systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Robust recruitment processes continued to be followed and there were sufficient skilled and experienced staff to meet people's needs. We found appropriate numbers of staff were deployed to meet people's needs.

There continued to be safe systems in place for the management of medicines. Medicines were administered safely and administration records were kept up to date.

People received care from staff that had received training and support to carry out their roles.

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

People's care preferences, likes and dislikes were continued to be assessed, recorded and respected, their care provided in line with up to date guidance and best practice. People’s cultural and religious needs were taken into consideration at the time of assessment and reviews.

We found that there was collaborative working with other community healthcare professionals to ensure that people received coordinated and person-centred care and support. People were supported to maintain a healthy lifestyle.

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

People continued to receive care from staff that were caring, kind and compassionate. People were treated with dignity and respect and staff ensured their privacy was maintained when care was provided to them.

People were encouraged to make decisions about how their care was provided and staff demonstrated a good understanding of people's needs and preferences.

Staff understood the Mental Capacity Act 2005 and how to support people's best interest if they lacked capacity. 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.

There continued to be policies in place. People were 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.

The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement.

The provider knew how and when they should escalate concerns following the local authorities safeguarding protocols. Procedures for reporting safeguarding concerns continued to be in place.

The provider continued to have 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 meetings with other healthcare professionals.

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 had plans in place to ensure it could run in the event of emergencies arising so that people’s care would continue.

Quality assurance audits continued to be carried out to identify any shortfalls within the service and how the service could improve.

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

Further information is in the detailed findings below.