Gravesend Care Services

Updated 30 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 23 May 2017 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available. The registered manager was absent from work on planned leave and the deputy manager arranged to meet with us.

The inspection was carried out by one inspector.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Prior to the inspection we also looked at notifications that the provider or registered manager had sent us. A notification is information about important events which the service is required to send us by law.

We spoke with three people who received personal care from the service, and two relatives, to gain their views and experience of the service provided. We also spoke to the deputy manager and two members of care staff. After the inspection we asked health and social care professionals for their views of the service.

We looked at three people’s care files and four staff records as well as staff training records, the staff rota and staff meeting minutes. We spent time looking at records, policies and procedures, complaints and incident and accident recording systems, medicine administration records and quality assurance systems.

We asked the deputy manager to send us audit action plans after the inspection and they sent these within the time requested.

Updated 30 June 2017

This inspection took place on 23 May 2017. The inspection was announced.

Gravesend Care Services is registered as a domiciliary care agency, providing personal care specifically to people living within a supported living service who have a learning disability or mental health need. Set within the larger Wimborne House extra care complex, people live in their own self-contained flats. There were ten people receiving support with their daily living from Gravesend Care Services, however not all of these people required support with their personal care needs. Four people required support to meet their personal care needs on the day we inspected.

The provider had been registered to provide personal care services at this location since 16 May 2016 when the new building was completed. Some people had been living there since May 2016 and others had moved in as recently as February 2017.

There was a registered manager based at the service. 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 registered manager was available at the service for ten hours per week as they managed other services within the providers group.

People were given information in a way they could understand about how to stay safe and who to tell if they did not feel safe. Staff were fully aware of their responsibilities in keeping people safe and reporting any concerns they had. They were shown how to report directly to the local authority if they needed to.

Individual risks were identified and management plans to reduce and control risk were comprehensive, making sure people and staff had the guidance they needed. Accidents and incidents were recorded in detail by staff with action taken. The registered manager had not always kept up to date with checking the process had been completed, however this was being addressed by a change to the reporting process.

Most people managed their own prescribed medicines if they had them, or required only reminding or prompting. Two people did need assistance with the administration of their medicines. Records to do with the safe administration of medicines were kept well and monitoring systems to check records had been started by the registered manager.

There were enough staff to provide the support people had been assessed as requiring. Staff support and the times it was given was tailored to the individual, changing when necessary to suit people’s changing needs and wishes. Safe recruitment practices were followed by the provider and the registered manager to make sure only suitable staff were employed to work with people in their own homes.

Staff were supported well by the provider and the management team. Training was generally up to date and staff were encouraged to pursue their personal development. Staff had received one to one supervision although this was not as regular as the provider’s policy stated it should be. Staff saw the deputy manager on a daily basis and felt well supported. Regular staff meetings were held to aid communication within the team.

People were supported to make their own choices and decisions. Staff had a good understanding of the basic principles of the Mental Capacity Act 20015 (MCA) and promoted people’s rights. Where people needed support with some decisions they were helped by a close family member. As people were living within a supported living service, they had a tenancy agreement, protecting their housing rights. They were supported to understand their responsibilities by staff and were provided with an easy read guide to support their understanding further.

Some people needed the assistance of staff to cook their meals. The support required was detailed within their support plan. Most people had the support of a family member with their health care needs, making and attending appointments. When a family member could not support, staff made sure appropriate referrals were made and followed up. Good relationships were developing with health and social care professionals.

People had access to many different activities of their choice outside of the service and were supported to pursue and maintain these. Within the service, people had been supported to set up activities they said they wanted to do together. Regular residents meetings took place and people ran these themselves, chairing and taking notes, with staff attending to answer questions and take actions away. People were regularly asked their views of the service and action was taken by the registered manager to respond where necessary.

There was clear evidence of the caring approach of staff. People were very positive about the staff who supported them, describing them as kind, caring and lovely. A small staff team provided support so staff knew people well and were able to respond to their needs on an individual basis. A theme of promoting people’s skills and confidence, supporting them to move on to greater independence ran through everything staff did.

Auditing processes were in place to check the safety and quality of the service provided. Some audits, such as the care plan audits, were not completed as regularly as the provider intended them to be. We have made a recommendation about this.

The people we spoke with thought the service was well run and were happy with the service provided. People and their family members knew the registered manager and deputy manager well and were complimentary about the support they received.

Staff said they were well supported and found the management team to be very approachable. They felt they were listened to and when they had suggestions to make these were acted on when possible.