We carried out a review of the data available to us about Cera- Kent 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 Cera- Kent, you can give feedback on this service.
Cera Care- Kent is a registered domiciliary care agency, providing personal care to people in their own homes in the community. They provide services to any people who need care and support. The agency provides care services to people living in Kent. There were 67 people using the service on the day we inspected. 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.
People’s experience of using this service and what we found
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 and their relatives told us they felt safe using the service and care staff knew how to report concerns. Risks to people and staff were well managed through risk assessments, which were regularly reviewed. There were enough staff to meet people’s needs, people told us they had continuity with their carers and they always stayed for the duration of the call. People received their medicines safely from staff that were trained and regularly competency assessed. Staff were following guidance around the use of personal protective equipment (PPE) during the current pandemic. The management team were spot checking this and people told us staff were wearing PPE at all times.
People received personalised care responsive to their needs. Care plans were regularly reviewed and updated to ensure they were reflective and up to date. People told us they were involved with planning their care and participated in reviews. Staff knew people well and were able to tell us about people’s likes and dislikes. No one was receiving care at the end of their life but the manager told us about new care plans they are putting together in case they needed them in the future.
People, relatives and staff were positive about the management of the service. Feedback we received told us that the management team had an open door and they knew where to go if they had concerns. The manager knew their roles and responsibilities and had recently applied to be registered with the Care Quality Commission. Quality assurance systems were in place to monitor and improve the service people received. Regular communication was continued with people through letters and regular phone calls. The manager had made changes to improve how the service was being run and it had made a positive impact to staff and people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 10 June 2019) and their was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cera- Kent 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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People’s experience of using this service:
¿ People and their relatives told us the agency had improved for the better since the last inspection. People were happy with the care and support they received from staff. One person said, “The carer I have got is absolutely brilliant. She does everything for me really; I would be totally lost without her.”
¿ The management team had started to review and update people’s care records with them. However, some records had not been reviewed and updated despite changes to their needs.
¿ Care records were not consistently personalised nor did they contain all the knowledge from staff working with them at each care call.
¿ People’s safety in the event of a fire at an extra care housing scheme had not always been assessed. Other potential risks posed to people and staff had been mitigated.
¿ Records to show how decisions were made on behalf of people who lacked capacity did not always evidence how particular decisions were made in their best interests.
¿ The registered manager had a continuous improvement plan which they were working through. Several changes had been made since the last inspection however, the management team continued to make further improvements.
¿ There were enough staff to meet people’s needs. Staff had been recruited safely following the provider’s policy and procedure.
¿ People received their medicines safely from staff that were trained and competency assessed.
¿ Staff were supported in their role and received continuous training and development to meet people’s needs.
¿ Staff were kind, caring and patient with people. Information about people’s personal histories, likes and dislikes had been recorded within their care records. One person said, “They are very kind and caring. They are very friendly. They are very nice people.”
¿ Staff worked alongside health care professionals to promote people’s health and nutrition.
¿ Communication was promoted through regular newsletters to people.
¿ Regular audits were used to monitor and improve the quality of the service people received
The agency met the characteristics of Requires Improvement in Safe, Effective, Responsive and Well-led; The Caring key question was rated as Good.
Rating at last inspection: Requires Improvement overall with Inadequate in well-led (Report published 3 December 2018). This service has been rated Requires Improvement at the last inspection and this inspection.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Enforcement: Action we told provider to take refer to end of full report
Follow up: We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated Requires Improvement.
Mears Care Limited (Maidstone) is a domiciliary care agency which provides care and support for people in their own homes. Care is provided for a range of people including older people and people with dementia. The service operates in areas including Margate, Ashford and Medway. Not everyone using Mears Care receives a 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 there were 173 people using the service.
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.
There were not enough staff to meet the needs of those using the service. This meant people received support which was later than their preferred time, or sometimes did not receive support at all. People were not being respected because they were not being informed of changes to their support, and they told us the uncertainty made them feel anxious. Improvements were not always made effectively as a result of complaints, for examples the service continued to take on additional clients even though people were complaining that there were not enough staff to meet the needs of those already using the service.
People did not always receive their medicines in a safe way. Audits on people’s medicine records were not being fully completed, and where errors were identified, these were not always followed up or sufficient steps taken to learn from mistakes. Overarching quality assurance audits of the service were not taking place, so the registered provider was not aware of all the concerns we identified during our inspection.
People were not always receiving care according to their personal preferences. Records showed people’s personal preferences were not always considered when providing care. Information was not always being presented to people in a way they could understand.
People were protected from abuse by staff who were trained in how to identify and report abuse. They told us they thought any concerns they had would be treated seriously by their managers. Risks to people were assessed and steps were taken to reduce the risks. Checks were made to ensure newly recruited staff were recruited in line with nationally recognised guidance and best practice.
People’s needs were assessed before they started to receive support from staff, but care was not always delivered according to these assessments. Assessments took into account peoples protected characteristics such as their ethnicity and sexuality. Staff were trained to have the skills and knowledge to deliver effective care and support. Newly recruited staff completed a week long induction. Where responsible, staff supported people to eat and drink enough to maintain a balanced diet.
Staff made referrals to health professionals when required, and worked together to ensure that people received consistent and person-centred support when they moved between different services. The registered manager was working with professionals such as district nurses and occupational therapists to ensure people received joined-up care. When people lacked the capacity to consent to care, staff sought consent from people in line with best practice legislation.
People told us care staff treated them in a compassionate manner, and were mindful of their dignity. Staff supported people to be involved in making decisions about their care. People’s personal and confidential information was kept secure. There were procedures in place if people needed support at the end of their life.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about the Care Quality Commission's regulatory response will be added to the report after any representations and appeals have been concluded.
We found an additional shortfall in the service in relation to which we have made a recommendation. This was because the registered provider was not always providing information to people in a way they could understand.
This is the first time the service has been rated Requires Improvement.