Expertise Homecare (Canterbury and Coastal) is a domiciliary care service and is a franchise of the Expertise Homecare brand. It provides personal care to people living in their own homes in the community. The service is provided to mainly to older adults, some of whom have complex needs such as dementia or complex health conditions. The service supports people in Canterbury and surrounding rural areas. Not everyone using Expertise Homecare (Canterbury and Coastal) 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 inspection 59 people were receiving the regulated activity of ‘personal care’.

The service had a registered manager in post. A registered manager is a person who is 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.

Staff were not always recruited safely. This was because the registered manager did not take all the necessary steps to ensure they knew the previous conduct of newly recruited staff. People did not always receive their medicines safely. We found staff were not following best practice guidelines when administering controlled drugs. We made a recommendation about this. The registered manager had not always taken steps to learn lessons when things went wrong to keep people safe. Some people and staff might be at risk because risks were not always being fully documented.

People’s needs were assessed before the service began, but we found some needs were not fully recorded. Newly recruited staff were supported with an induction, but progress was not always tracked in accordance with the registered provider’s guidelines. Staff were knowledgeable about the Mental Capacity Act, but records were not always accurate or up-to-date.

We found the registered provider had not always acted on complaints in a timely manner. This had a negative impact on the person making the complaint. People’s care plans did not always contain detail about their needs or preferences. This included how they wished to be supported at the end of their lives. People did not receive information about their care in an accessible format. People and their relatives told us they had not seen all of their care records because they were on a computer system which they did not know how to access. We have made a recommendation about this.

Governance systems were not always effective in making sure that shortfalls in service delivery were identified and rectified. The registered manager was unaware of the shortfalls in, for example, the recruitment procedures or care plans which we identified during our inspection. Not all the staff we spoke with were clear about what was expected of them. This was because job descriptions were not always changed when staff’s roles changed. Although staff were not supported with regular meetings or supervisions, they told us they felt supported by their manager and senior staff.

People were protected from abuse. Staff were knowledgeable about the types of abuse which could occur, and knew what action to take if they had concerns. People were protected by the prevention and control of infection. Staff had access to, and used, protective equipment, and received regular training which helped them keep people safe.

Staff received sufficient training in order to meet the needs of those being supported. Where people had specialist needs, additional training was provided. When required, people were supported to eat and drink enough to maintain a balanced diet. Staff worked across organisations to ensure people received joined up care and support. People were supporte

This was the first inspection to this service since its registration and the inspection was announced.

Expertise Homecare is a domiciliary care service provided to people living in their own homes. The service currently provides support to people with a wide range of care needs, including both younger and older adults with physical disabilities and sensory impairment, learning disabilities and dementia and provides support to people with mental health needs, eating disorders, and people who misuse drugs and alcohol. At the time of the inspection 30 people were using the service.

A registered manager is currently in post and was present on the day of the inspection. 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.

Everyone we spoke to said they felt safe when being cared for by the care staff of Expertise Homecare. There were clear risk assessments and equipment used was checked for safety and staff had training to make sure they were competent to use it. The registered manager and care staff worked closely with local health and social care professionals to support people’s health and wellbeing and make sure people were well hydrated and nourished. People had the help they needed to take their medicines and there were clear procedures to follow to assist them safely. When people were nearing the end of their life, the care staff worked alongside the hospice nurses to assist to make sure people were as comfortable as possible and had their wishes adhered to.

All care staff carried an encrypted electronic tablet that contained people’s care plans and all the information relevant to give each person the right care and support. Records were kept confidentially and could only be accessed on a need to know basis using a series of passwords.

There was an open and person centred culture based on the values of the organisation of trust, transparency, quality and support. The registered manager was known by everybody using the service because he visited people regularly and kept in touch. People and relatives told us that the registered manager was friendly, helpful and easy to contact. People praised the efficient communication between the registered manager and staff team, commenting that care staff were always well informed and if they wanted to speak with the registered manager he always had time for them. The registered manager gave care staff weekly updates and any changes regarding people’s care was sent to them by email as soon as possible and care plans reviewed and updated.

People said the care staff were reliable and always arrived at the time they said they would. People had a rota of times that they would receive care. Staff were on time and if they were going to be delayed would always call to let people know. Care staff explained that there was always plenty of time allocated to them to give people the care in the way they wanted. The registered manager explained that the company was expanding but they were doing this slowly to make sure they did not over-stretch the staff. He went on to say that they always checked the timings and staffing level was sufficient before offering a new care package.

People were full of praise for the caring nature of the care staff and the leadership of the service. Staff were recruited safely and received essential training at the beginning and were introduced to people by experienced care staff before they supporting people. Staff said they felt confident in their roles and the registered manager was always at hand if they needed any support. Staff said the training was good and included attending events and they had to experience some of the care as part of the training, for example, being hoisted