About the service:

• Chameleon Care is a domiciliary care agency which provides personal care to people in their own homes.

• They operate in and around Dover and surrounding areas.

• At the time of the inspection the service was supporting 63 people and there were 32 staff.

• 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:

• The service enabled people to receive care in their own homes. One person told us, “I like being in my own home. The girls help me do things; they are like family.”

• People had good relationships with staff, who were knowledgeable of their physical and emotional needs, as well as likes, dislikes and interests. Staff were responsive to changes in people's health needs. If needed, they sought advice from relevant professionals.

• People felt safe living at the service.

• People were encouraged to be as independent as possible.

• People felt comfortable raising any complaints with staff and the registered manager.

• People were fully involved in their care planning and received information in a way that they understood.

• People were protected from the spread of infection and medicines were stored and managed safely.

• People were asked feedback about the service they received.

• People found the registered manager approachable and supportive.

Rating at last inspection: This service was rated, “Good” at the last inspection. (17 February 2017)

Why we inspected: This was a planned comprehensive inspection to check the service remained Good.

Follow up: We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.

Care Service Description

Chameleon Care provides domiciliary care to people with physical disabilities, older people, people living with dementia and people who are terminally ill. There is also a sit in service, escorting, waking night and night sleep in service. The service currently provides services in Dover and surrounding villages. There is also a branch of the agency in Dartford, Kent. The service, which is open during office hours, has designated office-based staff and an on-call system.

Rating at last inspection

At the last inspection, the service was rated Good and Requires Improvement in the ‘safe’ domain.

Why we inspected

We carried out an announced comprehensive inspection of this service on 28 June 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safe care and treatment, relating to medicines management.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Chameleon Care (Dover) on our website at www.cqc.org.uk

Why the service is rated Good

At this inspection we found the service remained rated as Good overall and is now rated Good in the safe domain.

Why the service is rated Good

The service had improved since the last inspection. Medicines were now being administered safely and records were up to date and completed appropriately.

People told us they felt safe using the service and they trusted the staff. Staff knew how to recognise and respond to abuse. They had received training on how to keep people safe.

Care records included risk assessments of people’s mobility together with detailed guidance about how to move people safely and consistently. Regular checks were made on the equipment in people’s homes to ensure it was safe to use.

Accidents and incidents were recorded and monitored to look for patterns and trends to reduce the risk of reoccurrence.

There were sufficient numbers of staff on duty at all times to ensure that all calls to people were covered and people’s needs were met. There had been no missed calls and people said the staff were reliable and consistent.

Plans were in place to ensure that the service would continue to run in cases of emergency and on call arrangements ensured that staff were supported by a manager should they need additional guidance outside of office hours.

New staff had been recruited safely and checks were carried out on staff to make sure they were suitable and safe to work with people.

The inspection visit took place at the service’s office on 23 and 24 May 2016.

Chameleon Care provides domiciliary care to people with physical disabilities, older people, people who are living with dementia and people who are terminally ill. There is also a sit in service, escorting, waking night and night sleep in service. The agency currently provides services in Dover and surrounding villages. There is also another location in Dartford, Kent. The service is open during office hours, has designated office-based staff and an on-call system. At the time of the inspection 35 people were receiving a service.

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 registered manager was responsible for overseeing the Dartford and Dover locations. The registered manager was based at the Dartford office and a senior manager was responsible for the day to day control of the Dover location. At the time of the inspection the senior manager and administration staff assisted the inspector.

People told us they received their medicines regularly and staff had been trained to administer medicines. However, medicine records were not completed accurately to clearly show that people had received their medicines safely.

Staff had received safeguarding training and demonstrated a good understanding of what constituted abuse and how to report any concerns. Procedures were in place to report and escalate any concerns to the local authority safeguarding team.

Risks associated with people’s care had been identified, and detailed guidance was in place to ensure that people were supported as safely as possible. Some people could display behaviours that challenge due to their anxieties and risk assessments were in place to guide staff with the strategies to adopt to positively support people when such occasions occurred.

There were systems in place to monitor incidents and accidents and to take appropriate action. There was a business continuity plan in the case of an emergency, such as fire, flood or the breakdown of the technical systems.

The service also operated an ‘out of hours’ system for people or staff to ring if they needed additional assistance during evenings and weekends.

Some people had equipment in place to aid their mobility, such as bathing aids. Staff were aware that the equipment needed to be serviced to remain safe, and systems were in place to confirm the equipment was being serviced according to the manufacture’s guidelines.

People told us that they had never experienced a missed call as there were always staff available including cover for sickness and annual leave. They told us that they received a service from regular staff, who arrived on time and stayed the duration of the call. People said the service was flexible and provided additional calls if they needed extra help.

Staff were recruited safely with all relevant checks in place to ensure they were safe and suitable to work at the service. New staff completed an induction programme, which included attending training courses and shadowing experienced staff before they started working on their own. People felt that staff were well trained and understood their needs. A training programme was in place to ensure that staff had the skills and competencies to carry out their role.

Staff were supported to discuss their role through regular one to one meetings with a senior member of staff. Annual appraisals ensured that staff had the opportunity to discuss their training and development needs. All staff received ‘spot checks’ when they were providing care in the community to ensure their skills and competencies were