Archived: PCAS Kent Ltd

Updated 29 September 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 comprehensive inspection took place on 8 and 9 August 2018 and was announced. We gave the service short notice of our inspection to ensure that people using the service could decide if they wished to receive a telephone call from us and to ensure we had the correct contact details for people and their relatives.

The inspection was carried out by one inspector and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Inspection site visit activity started on 8 August and ended on 9 August 2018. On 8 August, we made telephone calls to people that used the service and their relatives. We also met with people using the service and we visited the office to review the documents associated with the running of the service. On 9 August we made further telephone calls to staff and external health and social care representatives to gain their feedback on the service.

Before the inspection took place, we looked at information we held about the service including registration information and statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law. On this occasion we did not ask the provider to send us a provider information return (PIR). This is information we ask providers to send us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information with us that they felt was relevant, during and following the inspection process.

During our inspection we spoke with the registered manager/director, another director and three care staff. We also spoke with three people who used the service and six relatives. We looked at a range of documents and written records including four people's care records, three staff recruitment records and information relating to staff training and the auditing and monitoring of service provision.

Following our inspection, we gathered further feedback about the service from health and social care professionals who worked closely with the service.

Updated 29 September 2018

This inspection took place on 8 and 9 August 2018 and was announced.

PCAS Kent ltd is a domiciliary care agency. It provides personal care to people living in their own houses in the community and provides care and support to people living in 'supported living' settings, so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. This was the service first inspection since they registered with CQC in August 2017.

Not everyone using PCAS Kent Ltd 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. At the time of the inspection, the service was supporting eight people with their personal care needs. This included older people, younger adults and people with complex health needs such as epilepsy, dementia and mental health. People who use the service live in Gravesend, Isle of Sheppey, Maidstone and the surrounding areas.

The service had a registered manager. 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, who was also the provider and director was supported in their role by a director, finance manager, office administrator and a team of four supported living managers. The provider was also actively recruiting for a service manager, who would have the responsibility for the day to day management of the service.

People were at the heart of the service. Staff demonstrated thorough understanding of each person's individual needs and preferences and used this knowledge to provide them with flexible, responsive support which enhanced the quality of their lives.

People, their relatives, health and social care representatives consistently told us staff were very caring and always treated people with great respect and empathy. People told us staff knew how to meet their needs, were kind, always respectful and well trained. Staff were empowered to work creatively and to develop positive relationships with people. Staff were proud of the support that they provided to people and the positive outcomes that they had observed.

People were safe using the service. People told us they felt safe and comfortable when staff were in their home and when they received care. Recruitment practices ensured the right staff were recruited to support people to stay safe. Staff told us they were happy in their jobs and had access to training. They said they felt well supported and had regular opportunities to discuss their work. The rotas reflected the support people required to maintain the choices they had made, and as a result the staffing arrangements were flexible to meet those needs. A number of people received care from staff on a one to one basis and records showed that people received their care in the way they needed to maintain their safety.

People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medicines administration records (MAR) after giving people their medicines. MAR sheets were audited to ensure people had received their medicines as prescribed.

Support plans and risk assessments were developed from the initial assessment information. Support plans were comprehensive, individualised and developed with each person. They described the support the person needed to manage their day to day health needs. Risks to people were identified and guidance and control measures were in place to enable staff to support people safely.

People's communication needs were met. The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss. Information was provided to people in an accessible format to enable them to make decisions about their care and support.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People's care records documented whether they had capacity to make specific decisions. Staff told us they gained consent from people before carrying out personal care and respected people's choices.

People's health and well-being was monitored by staff and they were supported to access healthcare services in a timely manner when they needed to. The service worked in partnership with health and social care representatives to meet people's needs and helped reduce avoidable hospital admissions. The service was responsive and quick to adapt to meet people's changing needs. People were supported to have sufficient amounts to eat and drink to maintain a balanced diet.

The registered manager and director were prominent role models. They took a leading role in demonstrating the values and standards they expected staff to demonstrate by focussing on continuous improvement, leading to positive outcomes for people.

The service used feedback as an opportunity to learn and improve. People were consulted about how their care was delivered and given opportunities to feed back about how they felt the service was doing. People told us they were completely satisfied with the service they received and said they had no reason to complain about the service but were confident any complaint would be handled properly if they did.

There were quality assurance systems in place to monitor the quality and safety of the service and to drive improvements.