About the service:

ComCare provides domiciliary care and support service for people living with a range of disabilities. The office is based in the grounds of Strode Park Foundation for People with Disabilities. The agency currently provides services in Whitstable, Herne Bay and Canterbury. The office was open during office hours, had designated office-based staff and there was a 24 hour on-call system. At the time of the inspection there were 49 people receiving a service. ComCare also provides an ‘Outreach’ service of support workers who support people for longer periods, for example, half and whole days.

People’s experience of using this service:

People were very happy with the care and support they received from ComCare. Staff knew people well and people's preferences were respected. In addition, when people began receiving support from the service, staff were matched to them by shared characteristics such as; age or interests. The same staff supported people as much as possible as the provider understood that consistency was important for the people they supported.

People and their relatives were actively involved in developing their person-centred support plan and these were regularly reviewed with people to ensure they continued to meet people's needs. People were regularly asked for their feedback, through written surveys and verbally by staff. Every person we spoke to told us that they would feel confident and comfortable raising concerns with staff but had never felt the need to make a complaint.

Staff had the training and support to provide people with the support they needed. Rotas were sent to people each week, so they were aware of when their calls would be and with what member of staff - people told us that they found this useful. People were kept updated if staff were running late. People told us that staff had never missed a call, even during periods of heavy snow.

Most people did not need support with medicines. However, medicine checks were carried out for those who did require assistance to ensure they were given to people safely. Some people needed support with meals, but people decided what they wanted to have and be supported to do as much as they could for themselves.

People were supported to develop their skills and independence, such as; learning to cook, clean and use public transport. Every person we spoke to told us that staff was respectful of their privacy and dignity.

There were systems and processes in place to monitor the quality of the service provided to people and there was an open and transparent culture which encouraged people and staff to raise concerns and ideas to improve the service.

More information is in Detailed Findings below.

Rating at last inspection:

Good (published 17 August 2016)

Why we inspected:

The inspection was planned based on previous rating.

Follow up:

We will continue to monitor the service.

The inspection took place at the service’s office on 14 and 15 July 2016.

Comcare provides domiciliary care and support service for people with living with a disability. The office is based in the grounds of Strode Park Foundation for People with Disabilities. The agency currently provides services in Whitstable, Herne Bay and Canterbury. The service is open during office hours, has designated office based staff and an on-call system. At the time of the inspection there were 50 people receiving a service. Comcare also provides an ‘Outreach’ service of support workers who support people for longer periods, for example, half and whole days.

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 the day to day control of the service. They were supported by a service lead, and team leaders.

The registered manager had recognised, due to recent reduced staffing levels, staff competency ‘spot checks’ and one to one supervision meetings had not taken place as regularly as they would have liked. They had taken action to address this shortfall and agreed this was an area for improvement.

People told us they felt safe and trusted the staff that supported them. Staff knew how to protect people from the risk of abuse and the action they needed to take to keep people safe. Staff completed regular training about how to keep people safe. The provider had a whistle-blowing policy and staff knew they could take any concerns to other organisations if they had concerns. Staff said they felt confident to whistle blow.

Assessments identified specific risks to individuals and provided guidance to staff on how to minimise risks. The registered manager monitored and reviewed accidents / incidents and analysed them to identify any trends. When a pattern had been identified action was taken by the registered manager to refer people to other health professionals and minimise risks of further incidents and keep people safe.

There was sufficient staff employed to give people the care and support that they needed. People told us they received care from regular staff and their calls were always covered in times of sickness and annual leave. People commented, “Happy with the service provided and always get informed of changes” and “Always informed if carers are late”.

The provider’s recruitment and selection processes were robust, thorough and co-ordinated by the provider’s human resources department. The provider’s policies were followed when new staff were appointed. Checks, including references and criminal records, were completed to make sure staff were safe to work with people.

People’s medicines were stored safely in their homes. Most people took their medicines independently with no involvement from staff. Some people did need prompting or support and guidance from staff to take their medicines as prescribed by their doctor. Staff were trained to support people with their medicines.

People said the service was effective and reliable. The provider had a comprehensive training programme and staff completed refresher training to make sure they had the skills and knowledge to carry out their roles effectively.

People felt informed about, and involved in, their healthcare and were empowered to have as much choice and control as possible. Staff understood the key requirements of the Mental Capacity Act 2005 (MCA) and how it impacted on the people they supported.

People were supported to maintain a balanced diet and to shop for and prepare their meals. Staff supported people to maintain good health. Staff knew people’s routine health

We visited the office and spoke with the manager, service lead, team leaders and eight care staff. Later we spoke with 12 people who used the service or their relatives. All of the people we spoke with were happy with the service they received.

People and relatives told us that they had given their consent and been involved in discussions about their care.

We found that people had care plans which were personalised to reflect their individual needs. One person said, “I have a care plan. It is being reviewed next week. They review it about every three months”. Another said, “They routinely come and review my care plan and if I have any concerns in the meantime I just ring the office. They are very approachable”.

People we spoke with told us that they felt the staff were well trained. They felt that ComCare recruited the right calibre of staff. One person commented, “The staff seem well trained”. Another person commented, “Most staff seem well trained. They tell us that they have training to keep them up to date”.

We found that there were appropriate systems in place to record medication.

People told us that they had been asked for their feedback on the service they received. They said that they completed annual surveys and that they were also asked for feedback at their three monthly reviews. People we spoke with said that they did not have any complaints but would contact the office if they had a problem and were confident they would be listened to.

We made an unannounced visit to the agency office and spoke with the Registered Manager. We spoke with four people who use the service and / or their relatives and also with staff.

People told us that, most of the time, they had regular carers which they preferred. One person told us that recently they had not had regular carers and that they missed not having the continuity of care. We were told, “ComCare are very good. I have no complaints at all” and, “ComCare give us a very good service”.

People said that hey were happy with the service they received. One person told us that they thought staff were, “Reliable, trustworthy and out of this world”.

Staff told us that they felt supported in their roles and had regular meetings and individual supervision. They also said that the training was, “Really good”.

We saw evidence that staff had their work quality checked by supervisors on a regular basis.