1 Southdowns View

Updated 16 May 2019

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

Inspection team:

The inspection was undertaken by one inspector.

Service and service type:

Kestrel Homecare, 1 Southdown's View is a domiciliary care service. It provides personal care to people living in their own homes. It provides a service to adults who require personal care and or social support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours' notice of the inspection visit because the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 10 April 2019 and ended on 16 April 2019. We visited the office location on 10 April to see the registered and office manager and office staff; and to review care records and policies and procedures. On 11 April 2019 we visited people and their relatives in their own homes with their consent. On 16 April 2019 we contacted people, relatives and staff by telephone.

What we did:

We reviewed the information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse. We assessed the information we require providers to send us at least once annually to give key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.

During the inspection, we reviewed a range of records including:

• Four people’s care records

• Staff files

• Notifications we received from the service

• Completed surveys from people who used the service

• Records of accidents, incidents and complaints

• Audits and quality assurance reports

• We spoke with five people who use the service and three of their relatives. We visited three people in their homes and spoke to others on the telephone.

• We spoke with the registered manager, office manager and three care staff

Updated 16 May 2019

About the service:

Kestrel Homecare, 1 Southdown's View is a domiciliary care service. The service is a family run business where the provider is also the registered manager.

It provides personal care to adults living in their own houses and flats in the community. At the time of the inspection the service was supporting 37 people, only 27 were receiving personal care. The service provides care and support for people in Heathfield and the surrounding area. CQC only inspects the service being received by people provided with personal care, where they do we also take into account any wider social care provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

People’s experience of using this service:

•The registered manager and office manager completed regular audits and checks on the quality of the service and look at ways to improve. However, shortfalls found at the inspection had not been identified and addressed.

•The registered manager had not ensured that all records were kept up to date. Staff supervisions were taking place, but the registered manager was not always recording these. Risks to people identified but these were not always recorded accurately in peoples care plans. These shortfalls had not directly impacted on the car and support people were receiving.

• At the last two inspections in 2015 and 2016 we recommended that the registered manager join a professional network for registered managers to ensure best practice and continuous drive to improve the service and keep up to date with best practise. This recommendation had not been addressed.

•People told us they felt safe and supported by staff in the way they preferred. Staff demonstrated good knowledge and received training on how to protect people from abuse. Staff could identify the forms of abuse and what they would do if the suspected or witnessed the different types.

•People spoke with staff about any potential risks to their health and welfare. These were assessed, monitored. Staff knew how to keep people safe from risks, however the potential risks were not fully recorded to make sure staff had clear written guidance on what to do to keep risks to a minimum and what action to take if the risk occurred. There were environmental risk assessments in place for staff.

•The registered manager made sure there was enough suitably trained staff to provide support to people. People said they were confident in the staff’s skills and abilities to look after them and keep them safe. Staff felt supported and valued. The registered manager checked that staff were undertaking their roles safely and effectively.

•Staff were recruited safely. Gaps in employment had been explored by the registered manager but a record of this was not available. People told us that they received their calls from regular staff who were on time and they had no missed calls. People received support from the registered manager and office manager when they needed it. They said there was always someone at the end of the phone.

•People's needs were assessed before they started using the service to make sure staff could deliver the care that they needed. People had agreed to the care and support they received.

•People had been able to plan their visits with staff and how they wanted their care provided. Care plans were developed and reviewed regularly.

•People were able to make decisions about their care and support and to maintain control of their lives. Staff supported people to do as much for themselves as possible.

•People said staff were kind, compassionate and caring and took their time to carry out their duties and did not rush. People said they were listened to and that they were treated respect.

•People told us they received their medicines when they needed them. Staff administered people’s medicines safely.

•People were supported people to access health care professionals when they needed them. The staff worked with other agencies to provide joined up care including specialist nurses when people were at the end of their lives. People were supported and cared for at the end of their life.

•People were protected from the risks of developing infections.

•When staff prepared meals for people, they were supported to have a range of nutritious food and drink that they had chosen.

•Care and support was given in line with legislation and guidance. Staff followed the principles of the Mental Capacity Act 2005 were followed. People's personal information was stored securely.

•People knew what to do if they had any concerns or complaint. They said they would be listened to and their concerns would be taken seriously and acted on.

•The registered manager was approachable and supportive and took an active role in the day to day running of the service. The culture within the service was transparent, personalised and open.

•People and staff were asked their opinions about the service. The results were analysed and action taken to address any issues. The opinions of other stakeholders were going to be sought.

The service remained ‘Good’ in safe, effective, caring and responsive but was ‘Requires Improvement’ in Well -led. There was breach of regulation 17.

Rating at last inspection:

Good (report published September 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained ‘Good’ in safe, effective, caring and responsive but was ‘Requires Improvement’ in Well -led. There was breach of regulation 17.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.