Kingsmith Care

Updated 28 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected this service as it was 24 months since it was rated ‘Good’. During this period we had not received any notifications relating to safeguarding concerns, accidents or incidents from the provider or other organisations.

This comprehensive inspection took place on 8 and 9 February 2018. We gave the provider 48 hours' notice of the inspection because we needed to ensure the registered manager would be available to speak with us.

Before the inspection took place we looked at information we held about the service including registration information and statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law. On this occasion we did not ask the provider to send us a provider information return (PIR). This is information we ask providers to send us at least once annually to give us some key information about the service, what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information with us that they felt was relevant, during and following the inspection process.

One adult social care inspector visited the provider's office location on 8 and 9 February 2018. We spoke with the registered manager of the service, a care manager, a compliance manager, a senior care worker with responsibilities for training and development and three other members of care staff. We looked at five records relating to staff recruitment, staff training and supervision, auditing systems and service quality monitoring. We looked at six people's care records and risk assessments, policies and procedures relating to the service and other relevant information.

Following the site inspection, an expert by experience spoke with four people using the service, four relatives and a friend of someone who used the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. We also contacted two healthcare professionals and a community professional involved in people’s care and support to gain their feedback about the service.

Updated 28 March 2018

Our last comprehensive inspection of this service took place on 7 December 2015. We rated the service ‘Good’.

At this inspection we found consistently good care delivery and excellent leadership. We rated the service ‘Outstanding’.

This inspection was announced and took place on 8 and 9 February 2018.

Kingsmith Care is a domiciliary care service providing personal care and support to adults. Whilst we have taken into account any wider social care and support provided to people in their homes and in the community, the Care Quality Commission (CQC) carried out this inspection only in relation to the regulated activity of 'personal care'.

At the time of our visit the service was supporting 24 people. Of these people, 13 were receiving support and assistance with personal care tasks. People who use the service live in Hammersmith and Fulham and the surrounding areas. People and their relatives consistently told us staff were very caring and always treated people with great respect and empathy.

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.

The company ethos is that ‘every action matters’. The registered manager told us their focus was on building trusting relationships and delivering care that brought about positive outcomes for people and their family members.

Without exception, we received excellent feedback from people who used the service, their relatives, health and social care representatives and community professionals. People were supported by a strong, stable staff team who knew them well and focused on ensuring they received the highest quality of care.

People told us they felt very safe and comfortable when staff were in their home and when they received care. People told us staff knew how to meet their needs, were kind, always respectful and very well trained.

Staff promoted people’s dignity and protected their privacy. People and their relatives were unanimous in their praise for the sensitivity and kindness of staff in relation to this matter.

Care plans and risk assessments were developed from the initial assessment information. Care plans were comprehensive in scope, individualised and developed with each person. They described the support the person needed to manage their day to day health needs.

Risks to people were identified in relation to falls, nutrition, skin care, and mobility. Risk assessments relating to each person's home environment were also being completed. Guidance and control measures were in place to enable staff to support people safely.

People's care and support was regularly reviewed and updated and appropriate referrals were made to external services to ensure people's needs continued to be met.

People’s care records documented whether they had capacity to make specific decisions and also contained a written record stating whether people had appointed someone as their Lasting Power of Attorney (LPA). Staff told us they gained consent from people before carrying out personal care and respected people's choices.

Recruitment practices ensured the right staff were recruited to support people to stay safe. Staff told us they were happy in their jobs, were paid well and had access to further training. They said they felt well supported and had regular opportunities to discuss their work.

People were protected from avoidable harm and abuse because the provider had effective safeguarding systems in place. Staff knew how to recognise the signs of potential abuse and understood how to report any concerns in line with the provider's safeguarding policy.

People were always visited by the same staff or small groups of staff to maintain continuity and build positive relationships. People who used the service and their relatives told us that the continuity of care was excellent, along with time keeping. People were provided with a copy of the staff rota so they knew who was due to visit them.

People's communication needs were met. The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss.

People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medicines administration records (MAR) after giving people their medicines. MAR sheets were audited to ensure people had received their medicines as prescribed.

The registered manager worked in partnership with healthcare and community professionals to ensure joined up; integrated care was delivered to people. They told us it was a pleasure to work with the provider.

Staff offered people a choice of their preferred foods and encouraged them to eat a healthy and balanced diet.

People were supported at the end of their life to have a comfortable, dignified and pain free death and the service worked closely with Royal Trinity Hospice and sought advice and guidance from palliative care nurses to ensure people remained comfortable and well supported.

The service sought regular feedback from people using the service and their relatives. People told us they were asked for feedback over the phone, via Skype, during visits and care plan reviews.

People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints.

The provider promoted openness and transparency within the service. Staff were encouraged to learn from past events through reflective practice, group discussions, supervision and appraisal systems.

Records were well organised and up-to date. Auditing systems were in place to monitor the quality of the service. The registered manager was keen to develop and improve the service. The whole staff team kept up-to-date with best practice by accessing professional websites.