Kent Social Care Professionals 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 living with dementia. The service operates in areas including Tonbridge, Tunbridge Wells, Paddock Wood, Sittingbourne and Medway. Not everyone using Kent Social Care Professionals 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 269 people using the service.

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.

Governance systems had not been fully embedded into the service. The registered manager had an oversight of and reviewed the daily culture in the service, including the attitudes and behaviour of staff. The registered manager promoted transparency and fairness within the workforce. People, their families and staff were encouraged to be engaged and involved with the service.

People were protected from abuse. Staff received training in how to identify different types of abuse. Risks to people and the environment were assessed and where issues were identified action was taken to mitigate the risk of harm. There were enough staff to meet the needs of those being supported. When people needed support with their medicines, they were helped in a safe way by staff that were trained. People were protected by the prevention and control of infection. Staff understood their responsibilities to report safety incidents, and improvements were made when things went wrong.

People’s needs were assessed before staff began to support them. The assessments took into account peoples protected characteristics such as their ethnicity and sexuality. Staff were trained to have to skills and knowledge to deliver effective care and support. Where responsible, people were supported to eat and drink enough to maintain a balanced diet.

Staff made referrals to health professionals when required. Staff worked together to ensure that people received consistent and person-centred support when they moved between different services. When people lacked the capacity to consent to care, staff sought consent from people in line with legislation. 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

Staff were encouraged to develop caring relationships with the people they supported. People’s dignity and independence was respected at all times. Staff supported people to express their views and be actively involved in making decisions about their care. People were involved in reviewing their care.

People were supported at the end of their life to have a comfortable, dignified and pain-free death. Records showed that staff worked closely with health professionals such as nurses from the local hospice, dieticians and GPs to ensure people had coordinated care at the end of their life.

People and their families were encouraged and supported to raise any issues or concerns with the registered manager. There was a formal complaints procedure in place, and details of how to complain were held with the person’s care records at their home.

We inspected this service on 23, 24 and 25 February 2016. The inspection was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the locations office to see us.

Kent Social Care Professionals domiciliary care agency 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 agency operates in areas including Tonbridge, Tunbridge Wells, Paddock Wood, Sittingbourne, Medway, Dartford and Gravesham. At the time of our inspection they were supporting approximately 700 people.

There was a registered manager in place. 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.

Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People were treated with dignity and respect by staff who also maintained people’s privacy.

People experienced a service that was safe. They received support and assistance from enough staff to fulfil their expected care packages and meet their assessed needs. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and recorded with measures put into place to manage any hazards identified.

Where staff were involved in assisting to managing people’s medicines, they did so safely. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

Staff had received the training they required to meet people’s needs. Staff had a clear understanding of their roles and people’s needs. Staff were supported in their role from the management team.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People were encouraged to be as independent as possible. Detailed guidance was provided to staff within people’s homes about how to provide all areas of the care and support people needed. People, if required were supported to eat and drink enough to maintain good health.

Systems were in place for monitoring the quality and safety of the service and assessing people’s experiences. These included telephone reviews, face to face reviews and spot checks.

The inspection was carried out by one Inspector and included a visit to the office; talking with the manager and staff; and speaking to people who use services over the telephone. We also talked with some relatives.

The agency was currently providing care to 96 people, and we telephoned 20% of people using the service. We chose these at random from the information provided by the manager during the visit to the office.

We found that there were suitable procedures in place for people’s care plans to be discussed and agreed with them prior to commencing the service.

We received a variety of comments from people about the services provided, but the majority said that the care was good and they were happy with the care staff provided. One person said "I am well satisfied. Some staff are good, and some are very good." Others were unhappy with unreliable timekeeping or a lack of continuity with care staff.

We found that there were processes in place for care staff to assist people with maintaining their food and fluid intake. However, two people said that “A lot of the staff cannot cook.”

The agency enabled staff to prompt or assist people with their medication, and staff had received appropriate training for this.

We found that the agency had suitable training procedures in place for new staff inductions and mandatory training.

The agency provided people with the opportunity to feed back information about the service; and had monitoring processes in place.

We obtained people’s views of the service by reading comments on recent quality assurance questionnaires; comments given to senior staff at care plan reviews; and by reading cards sent into the service.

We saw that people’s comments were generally very positive, and included the following:

“The help from the carers was appreciated very much.”

“I would like to thank you for all the helpful support you gave to me, and for the respect and professionalism shown at all times.”

“Just a note to thank all of the staff who cared for my relative. They all showed compassion, humanity, and tact in their everyday care.”

“The staff coped admirably with complex circumstances.”