About the service:

Safeharbour; Memory Well being Center is a registered charity and provides personal care and support to adults living with dementia, and those who care for them, in their own homes in the Dartford, Gravesham and Swanley areas. The service provides support to enable people to live as independently as possible.

People’s experience of using this service:

People and relatives described a service that was person centred. People and their loved ones were fully involved in decisions about their care and how it was provided which made sure they received individually led care and support.

People had mainly the same core group of care staff to provide their support which meant that staff got to know people and their families well and what was important to them. People said they felt safe.

The training staff received meant they were skilled in their role and people felt confident they knew what to do and understood their needs. Relatives described how staff had a good understanding of how living with dementia affects people and how to tailor their support.

Staff were well supported by the provider and registered manager and they said this meant they were in a good position to provide good quality care.

People knew how to make a complaint and they had the information they needed.

People, relatives and staff described a well run organisation who had people at the heart of what they did.

Rating at last inspection:

Good (Report published 29 October 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will visit the service again in the future to check if there are changes to the quality of the service.

This was an announced inspection that took place 28 and 29 June 2016.

Alzheimer’s and Dementia Support Services is a registered charity. Their Support at Home Plus service provides personal care and support to adults living with dementia and those who care for them in their own homes in the Dartford, Gravesham and Swanley areas. The service provides support to enable individuals to live as independently as possible. At the time of our inspection 55 people were using the service. The main office is located in Northfleet, Kent.

There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 previous registered manager had left 3 weeks prior to inspection and had started the process to de-register with the CQC. Interim management cover had been put in place and support was being provided by the operations manager and chief executive officer. A new manager was being recruited and shortlisting for the post was due to start the week following the inspection. The chief executive officer told us that the newly appointed manager would be registering with CQC as soon as they had completed their initial induction and training.

People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual care plans, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged them to do as much as possible for themselves.

Staff sought and obtained people’s consent before they provided support. Relatives told us that staff communicated effectively with the people they cared for, responded to their needs promptly and treated them with kindness and respect. People and their relatives were satisfied with how their support was delivered.

People’s privacy was respected and people were supported in a way that respected their dignity and independence. People received the support they required to ensure they had enough to eat and drink to maintain their health and wellbeing.

Policies and procedures were available for staff to support practice. There was a whistle blowing policy and staff were aware of their responsibility to report any bad practice.

There were robust recruitment practises in place to ensure that staff were safe to work with people. Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns.

Staff had completed the training they needed to care for people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported.

Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of recurrence could be reduced.

People’s individual assessments and care plans were reviewed regularly with their participation. People’s care plans were updated when their needs changed to make sure they received the support they needed.

All members of care staff received one to one supervision sessions to ensure they were supporting people based on their needs. Staff told us they felt valued under the leadership of the chief executive officer and operations manager. However annual appraisals had not taken place, a new appraisal system was scheduled to start in October. We have made a recommendation about this in our report.

Medicines were stored, managed and administered to people in a safe way. There was regular auditing of medicines and staff competencies were checked to ensure standards were maintain

Relatives and people using the service told us that they were involved in their care planning and decisions that affected them. One person said that the “Carers are genuine in what they do to help, know needs”. Staff that we spoke with told us how they encouraged people who use the service to remain independent. One member of staff said, “It has a feeling of helping people in their own home, no institutionalisation”. People were supported in promoting their independence and community involvement.

Relatives and people who use the service told us communication was good from the carers and service provider “Open honest, good communication”.

We spoke with the registered manager about how checks were carried out on people’s care plans to ensure that these were being maintained safely. The provider may find it useful to note that they were not always formally documenting these checks in order to evidence their assessment and monitoring of quality in this area.

The registered manager had introduced a system of monthly supervision for all staff. We reviewed completed supervision forms that staff had completed. Staff we spoke with confirmed that they found the supervision helpful to review and monitor their performance and the care of the people they were supporting.

At the time of our inspection the service was providing care and support to approximately 17 people with dementia. We arranged to speak with people who used the service and their relatives over the telephone. They told us that they were happy with the care and support provided by the service. Comments included “I am amazed by the quality of care it is absolutely fantastic” “I am happy with the care they provide” and “We could not cope without this service we are so pleased with it.” People told us that they were mostly visited by regular staff who understood their needs. They told us that staff were “Well trained” “Fantastic” “Passionate” and “Caring”. People told us that staff took time to help their relatives and understand their needs. We found that relatives and people who used the service had been involved in their care. One relative told us, “The manager carried out a full assessment and drew up a care plan with us.” Another relative told us that, “We were introduced to the care staff at the start to give my relative time to get to know them and understand the service.”

We spoke to the carers and families of people who received the service. Every one we spoke to was positive and complimentary about the service they and their relatives received.

People told us that they felt they received a personal service which centred on their relatives. They said that the service had made a "Real difference" to their lives. One person said "I don't know how I would have coped without the help they give to us" and another person told us that "Staff treat people like a real person and go at their own pace – there is no rushing".

People told us that they when they first started with the agency they met the registered manager who spent time with them getting to know what the needs of the person were. They said that they were always introduced to new care staff before they visited and that the registered manager always tried to make sure that care staff were compatible with the person they were visiting.

People told us that staff were "Real carers" and that they were respectful, kind and understanding.