KS Care

KS Care is a domiciliary care service providing personal care to people living in their own homes in the community. The service provides support to adults living with a physical disability or a sensory impairment including people who may be living with dementia, mental health needs, a learning disability or may be autistic. Some people were supported on a full-time basis by ‘live-in’ care staff.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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. At the time of our inspection there were 69 people receiving personal care at the service.

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

The management team’s governance systems were not always effective in monitoring the service or identifying where improvements could be made. This included areas such as visit times and durations being monitored. People did not always have the right care plans in place, and these were not detailed enough. There were limited overarching audits to monitor the quality of the service. The management team were not informing us of events which happened at the service in line with legislation and statutory guidance. We have made recommendations for the provider to review call monitoring systems and review and update people's care plans.

Despite our findings people were positive about the support from staff. One person said, ‘‘As far as caring staff go this service is the best. They take their time to make sure I am happy.’’

People and relatives told us they/ their family member were safe being supported by staff. There were enough staff to support people with their care visits. People were supported safely with medicines. Staff followed good infection and prevention control (IPC) practices.

Staff had the training and supervisions to be effective in their job roles. People were supported to eat and drink if this support was needed. Staff supported people to see health professionals if they needed this support. 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.

People told us staff were kind and caring and treated them with compassion. Staff made efforts to get to know people as individuals and support them in line with their preferences. People were supported to make choice about their support. Staff supported people with dignity and respect. People were supported to follow their social interests and pastimes if staff provided this support. The management team responded to complaints and concerns promptly. People were treated with dignity at the end of their life.

The management team were passionate about providing a good service and staff felt well supported in their job roles. People and the staff team were able to give feedback about the service. Staff worked well with other professionals to help people achieve good outcomes. The management team responded immediately to our feedback during the inspection and started implementing improvements.

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 13 June 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see all the sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to the way the service is managed at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will also request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

KS Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, people living with dementia, younger adults, people living with a physical disability, people living with mental health disorders and people living with learning disabilities or autistic spectrum disorder. People using the service were all being supported with the regulated activity which the service was registered to provide.

There were 34 people using the service when we completed the inspection. There was 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 service was safe. People were protected from harm and abuse and the registered manager and staff team had a good understanding of safeguarding procedures. People had risk assessments in place to protect them from harm. Some of these were limited in information and needed more detail to further mitigate risks when supporting people. There were enough staff to meet people’s needs. People received their care visits on time and for the correct duration. Staff members had necessary checks completed before starting employment including a disclosure and barring services (DBS) check. People were supported to take medicines safely. Guidance on administering some people's as and when required (PRN) medicines was not always clear. Staff members had a good understanding of infection control and how to support people safely with regards to this. Where incidents happened, these were investigated and actions were taken to ensure that lessons were learned.

The service was effective. Staff received regular training and supervision to ensure that they were competent in their job roles. The registered manager regularly checked and assessed staff's competency in all areas of their role. Assessments of people’s needs and support were completed thoroughly before they started using the service. People were supported to maintain their health and well-being. Action was taken if there were concerns about a person's health. The service worked with, and referred people to, other health and social care professionals to support people’s wellbeing. People were supported with their dietary needs where needed. People were 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 practic.

The service was not always caring. People’s care was not always as caring and respectful as it could have been as some people did not understand what staff were saying. This was due to some staff’s command of the English language. These staff would talk between themselves in their own language. Some people were rushed by staff or felt that they were treated quite ‘roughly’ by staff members. People were involved in making decisions about the care they received. People had the opportunity to remain as independent as possible and make choices about their care and support.

The service was responsive. People received care and support that was specific and individual to them. People’s care and support was reviewed regularly and changed to meet their needs. People were able to make complaints and compliments about the service they received. Complaints were responded to promptly and to the satisfaction of the complainant. People were supported with dignity and respect at the end of their life.

The service was well-led. The registered manager and provider had high expectations and values for the service which were shared with the staff team. People and staff were positive about the management of the service. Regular feedback was collected from people and staff and was used to produce action plans to improve the service. Effective links with professionals had been set up by the service to help deliver support to people focusing on their specific needs. Quality audits were carried out by the management team and were effective in monitoring and improving the quality of the support given to people. There was good oversight of care visits and the duration of these and action was taken if there was a risk of someone not receiving support. The service was keen to continually improve and was working hard to continually make peoples experience of using the service better.