ComCare

ComCare provides a support service for people living with a range of disabilities in various supported living houses. The office is based in the grounds of Strode Park Foundation for People with Disabilities. At time of the inspection ComCare were supporting 12 people however not all people received support with personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. There were 9 people being supported with personal care during this inspection.

People’s experience of using this service and what we found

We were told staffing had been a particular concern for the management team when they started working at the service in November 2022. They had identified inconsistencies in the teams and that there was not always enough staff to meet people’s needs. The manager described the previous culture amongst staff as poor. Improvements had been made at this inspection with people and their relatives telling us staff teams and support provided was improved and, “The manager is trying to get the right people. The right temperament and things are settling down. It is improving and staff are motivating people rather than just looking after them.”

Recruitment files had not been robustly audited, and we identified shortfalls in pre employment checks being completed before staff were working alone. Correct mitigation was in place, such as risk assessments but these checks were not followed up until inspection. All checks were completed before the end of our inspection.

Management of the service had gone through a recent change. The manager recently joined and told us they were “starting from scratch.” We were told they had apologised to people and their relatives when things had not gone well and had developed new audits and checks to drive improvement going forward.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The service was meeting the principles of Right Support, Right Care, Right Culture on this inspection.

Right Support:

People told us staff were polite, kind and respectful when supporting them with their personal care. Staff supported people to play an active role in maintaining their own health and wellbeing. Staff listened and amended peoples care as their needs changed. People were supported by staff to pursue their interests. A relative told us their family member went swimming, at least, “Once a fortnight and has lunch afterwards. They even went to Winter Wonderland in Hyde Park, London.” People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff showed kindness, compassion and support to people. One person told us the staff, “Understand me and help me get a shower.” They also told us staff supported them with changing their bed, making food and supporting them when they were frustrated. We saw people telling staff, “I love you,” and they were affectionate towards them holding their hands or hugging them. Relatives told us “(Staff member) is great I cannot rate them highly enough” and, “This is the place (person) has always chosen and feels the safest…(person) is extremely happy where they live.”

Right Culture:

People led inclusive lives because of the ethos, values, attitudes and behaviours of the management and staff. A relative told us, “Staff treat (person) as an individual, a buddy, they get the measure of him.” People were encouraged and supported to establish and maintain relationships with one another as well as with family and friends. We observed staff preparing a valentine calendar with one person, to assist them to count down the days till the event and observed staff supporting people with video calls with their family. Relatives told us the, “Staff are always helpful.” People told us they were excited about going home to their family and staff had supported them to prepare for their individual needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Relatives told us how staff had worked with their family member to organise a disco for their birthday including preparing all the invitations. They described the staff as “extremely caring and thoughtful.” They had made their relative “A cake, the most beautiful cake.”

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

Rating at last inspection

The last rating for this service was good (published 13 March 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

ComCare provides domiciliary care and support service for people living with a range of disabilities. The office is based in the grounds of Strode Park Foundation for People with Disabilities. The agency currently provides services in Whitstable, Herne Bay and Canterbury. The office was open during office hours, had designated office-based staff and there was a 24 hour on-call system. At the time of the inspection there were 49 people receiving a service. ComCare also provides an ‘Outreach’ service of support workers who support people for longer periods, for example, half and whole days.

People’s experience of using this service:

People were very happy with the care and support they received from ComCare. Staff knew people well and people's preferences were respected. In addition, when people began receiving support from the service, staff were matched to them by shared characteristics such as; age or interests. The same staff supported people as much as possible as the provider understood that consistency was important for the people they supported.

People and their relatives were actively involved in developing their person-centred support plan and these were regularly reviewed with people to ensure they continued to meet people's needs. People were regularly asked for their feedback, through written surveys and verbally by staff. Every person we spoke to told us that they would feel confident and comfortable raising concerns with staff but had never felt the need to make a complaint.

Staff had the training and support to provide people with the support they needed. Rotas were sent to people each week, so they were aware of when their calls would be and with what member of staff - people told us that they found this useful. People were kept updated if staff were running late. People told us that staff had never missed a call, even during periods of heavy snow.

Most people did not need support with medicines. However, medicine checks were carried out for those who did require assistance to ensure they were given to people safely. Some people needed support with meals, but people decided what they wanted to have and be supported to do as much as they could for themselves.

People were supported to develop their skills and independence, such as; learning to cook, clean and use public transport. Every person we spoke to told us that staff was respectful of their privacy and dignity.

There were systems and processes in place to monitor the quality of the service provided to people and there was an open and transparent culture which encouraged people and staff to raise concerns and ideas to improve the service.

More information is in Detailed Findings below.

Rating at last inspection:

Good (published 17 August 2016)

Why we inspected:

The inspection was planned based on previous rating.

Follow up:

We will continue to monitor the service.

Comcare provides domiciliary care and support service for people with living with a disability. The office is based in the grounds of Strode Park Foundation for People with Disabilities. The agency currently provides services in Whitstable, Herne Bay and Canterbury. The service is open during office hours, has designated office based staff and an on-call system. At the time of the inspection there were 50 people receiving a service. Comcare also provides an ‘Outreach’ service of support workers who support people for longer periods, for example, half and whole days.

There was a registered manager employed 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 responsible for the day to day control of the service. They were supported by a service lead, and team leaders.

The registered manager had recognised, due to recent reduced staffing levels, staff competency ‘spot checks’ and one to one supervision meetings had not taken place as regularly as they would have liked. They had taken action to address this shortfall and agreed this was an area for improvement.

People told us they felt safe and trusted the staff that supported them. Staff knew how to protect people from the risk of abuse and the action they needed to take to keep people safe. Staff completed regular training about how to keep people safe. The provider had a whistle-blowing policy and staff knew they could take any concerns to other organisations if they had concerns. Staff said they felt confident to whistle blow.

Assessments identified specific risks to individuals and provided guidance to staff on how to minimise risks. The registered manager monitored and reviewed accidents / incidents and analysed them to identify any trends. When a pattern had been identified action was taken by the registered manager to refer people to other health professionals and minimise risks of further incidents and keep people safe.

There was sufficient staff employed to give people the care and support that they needed. People told us they received care from regular staff and their calls were always covered in times of sickness and annual leave. People commented, “Happy with the service provided and always get informed of changes” and “Always informed if carers are late”.

The provider’s recruitment and selection processes were robust, thorough and co-ordinated by the provider’s human resources department. The provider’s policies were followed when new staff were appointed. Checks, including references and criminal records, were completed to make sure staff were safe to work with people.

People’s medicines were stored safely in their homes. Most people took their medicines independently with no involvement from staff. Some people did need prompting or support and guidance from staff to take their medicines as prescribed by their doctor. Staff were trained to support people with their medicines.

People said the service was effective and reliable. The provider had a comprehensive training programme and staff completed refresher training to make sure they had the skills and knowledge to carry out their roles effectively.

People felt informed about, and involved in, their healthcare and were empowered to have as much choice and control as possible. Staff understood the key requirements of the Mental Capacity Act 2005 (MCA) and how it impacted on the people they supported.

People were supported to maintain a balanced diet and to shop for and prepare their meals. Staff supported people to maintain good health. Staff knew people’s routine health needs and kept them under review.

People spoke positively about staff and told us they were kind and caring. People were happy with the care and support they received. Staff knew people well and were familiar with people’s life stories.

People were involved in writing their care plans. These were personalised and contained detailed daily routines specific to each person. Staff were knowledgeable about people’s likes, dislikes and preferences.

People told us they did not have any complaints but would speak to staff in the office if they had any concerns. They said that staff listened to them and sorted out any issues. Each person had a copy of the complaints procedure in their care plans in their home, and appropriate systems were in place to address any complaints.

There were systems in place to monitor the safety and quality of the service and risks were audited to keep people as safe as possible. People and staff were asked for their views and opinions through quality assurance visits, care plan review visits and an annual survey.

Services that provide health and social care to people are required to inform CQC of important events that happen in the service. CQC check that appropriate action had been taken. The registered manager submitted notifications to CQC in line with CQC guidelines.

People and relatives told us that they had given their consent and been involved in discussions about their care.

We found that people had care plans which were personalised to reflect their individual needs. One person said, 'I have a care plan. It is being reviewed next week. They review it about every three months'. Another said, 'They routinely come and review my care plan and if I have any concerns in the meantime I just ring the office. They are very approachable'.

People we spoke with told us that they felt the staff were well trained. They felt that ComCare recruited the right calibre of staff. One person commented, 'The staff seem well trained'. Another person commented, 'Most staff seem well trained. They tell us that they have training to keep them up to date'.

We found that there were appropriate systems in place to record medication.

People told us that they had been asked for their feedback on the service they received. They said that they completed annual surveys and that they were also asked for feedback at their three monthly reviews. People we spoke with said that they did not have any complaints but would contact the office if they had a problem and were confident they would be listened to.

People told us that, most of the time, they had regular carers which they preferred. One person told us that recently they had not had regular carers and that they missed not having the continuity of care. We were told, 'ComCare are very good. I have no complaints at all' and, 'ComCare give us a very good service'.

People said that hey were happy with the service they received. One person told us that they thought staff were, 'Reliable, trustworthy and out of this world'.

Staff told us that they felt supported in their roles and had regular meetings and individual supervision. They also said that the training was, 'Really good'.

We saw evidence that staff had their work quality checked by supervisors on a regular basis.