We carried out a review of the data available to us about Gravesend on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gravesend, you can give feedback on this service.
About the service
Gravesend is a domiciliary care agency and provides personal care to people living in their own houses and flats in the community. It provides a service to older people, younger adults and people with complex needs such as diabetes, autism, dementia and physical disabilities.
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 the inspection the service was supporting 26 people with personal care.
People’s experience of using this service and what we found
People and their relatives were positive about the care and support provided by the service. People told us they were supported in the way they preferred and felt they were involved and listened to.
Staff knew how to recognise and keep people safe from abuse and discrimination. Potential risks to people’s health and welfare had been assessed. There was guidance in place for staff to mitigate these risks. Staff understood their roles and responsibilities including infection prevention control.
People were supported by staff who were recruited safely and had the skills to support people’s complex needs. There were enough staff to meet people’s needs. People told us staff were on time and did not rush them. People were supported to take their medicines as required.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Relatives told us people’s privacy and dignity were respected by staff. People received person centred care, staff discussed with people and relatives their goals and aspirations. Relatives told us their loved ones were supported to be part of the community.
Checks and audits were completed on the quality of the service. People, relatives and staff were supported to express their views. People and relatives knew how to raise concerns and were confident action would be taken.
The registered manager and staff were passionate about providing high quality care. They had a vision for the future of the service to offer specialised support for people living with dementia and autism.
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 3 July 2018).
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gravesend on our website at www.cqc.org.uk.
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.
This is the first inspection of the service since their registration on 13 June 2017 with the Care Quality Commission.
Gravesend is a domiciliary care agency and provides personal care to people living in their own houses and flats in the community. It provides a service to older people, younger adults and people with complex needs such as diabetes, dementia and physical disabilities.
Not everyone using Gravesend 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. Where they do we also take into account any wider social care provided. There were nine people receiving personal care at the time of the inspection.
There was 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 also the provider.
The service had safeguarding and whistle-blowing procedures in place. Staff had received safeguarding training and understood their responsibilities to report any concerns and incidents of alleged abuse.
There was enough staff available to meet people's care and support needs. Risks to people had been assessed and reviewed regularly to ensure their needs were safely met.
Medicines were managed appropriately and people were receiving their medicines as prescribed by health care professionals.
Safe recruitment procedures were followed before new staff were appointed. Appropriate checks were undertaken to ensure staff were of good character and were suitable for their role.
Staff had the necessary skills, knowledge and experience to support people in their own homes. Staff completed an induction when they started work and they received training relevant to people's needs.
Staff received training in infection control and food hygiene and they were aware of the steps to take to reduce the risk of the spread of infections. Staff carried personal protective equipment like disposable gloves and aprons.
Assessments of people's care and support needs were carried out before they started using the service. Their care and support were reviewed on a regular basis to ensure their needs continued to be met by staff.
People's care files included assessments relating to their dietary support needs. Staff supported people to maintain a balanced diet and monitor their nutritional health.
Staff worked in partnership with health care professionals which helped improve the outcomes of people's health and well-being. Staff made referrals to health care professionals when people's care needs changed.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). 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 practice.
People told us that their choices and preferences were fully considered and the care records provided evidence of their involvement.
Staff treated people in a caring, respectful and dignified manner. People communicated their needs effectively and understood information in the current written format provided.
People and their relatives could raise concerns and appropriate actions were taken by the service to resolve their concerns.
Staff had access to out of hours on-call system that ensured management support and advice was always available for staff when they needed it and this allowed people’s care to continue at all times.
People, their relatives and staff spoke positively of the leadership and management of the service.
The registered manager monitored and reviewed the quality of the service. Audits were in place and where shortfalls were identified, actions were taken to make improvements.
The registered manager understood the requirements of their registration with Care Quality Commission (CQC).
Further information is in the detailed findings below.