About the service:

Angels Home Care (Kent) Limited is family run domiciliary care provider that was providing personal care to people in their own homes. People receiving support had a range of needs including, the elderly, people that were living with dementia and people who have a learning disability or autistic spectrum disorder. At the time of our inspection there were 66 people receiving personal care.

People’s experience of using this service:

¿ People told us they received a service where the staff felt like an extended member of their family. People said they received a quality service and would recommend the agency to others.

¿ People told us they felt safe with the staff who knew how to meet their needs, in the way they preferred. People’s needs were assessed prior to receiving a service. People’s protected characteristics under the Equalities Act were supported.

¿ People were at the centre of their care and support; care plans enabled people to maintain their independence. Care records were regularly reviewed to ensure they met people’s needs. Staff knew what action to take to protect people from the risk of abuse.

¿ People were provided with consistency and continuity of care with a small team of staff. Staff were to be recruited safely and the management team worked as part of the care team to ensure there were enough staff to meet people’s needs.

¿ Potential risks posed to people and staff had been mitigated. Staff supported people to attend healthcare appointments and express their views about their support. Staff worked alongside health care professionals to promote people’s health.

¿ People told us staff were skilled in carrying out their role. Staff said they were supported by the management team, who they saw on a regular basis.

¿ People told us the staff were kind and caring; staff promoted people’s privacy and dignity at all times. Staff responded to people’s emotional needs which had been included within their care plan.

¿ People, staff and others were encouraged to raise any concerns they had or make suggestions to improve the service.

¿ The management team promoted an open culture where staff were kept informed about any changes to their role. Staff told us they enjoyed working for the agency, and that the management team were approachable and listened to their ideas and suggestions.

¿ Systems were in place to monitor the quality of the service; spot checks and reviews were carried out by the management team.

Rating at last inspection:

This service was rated, “Good” at the last inspection on 13 July 2016. We published this rating on 24 August 2016.

Why we inspected:

This was a planned comprehensive inspection to check the service remained Good. We found overall that the service continued to meet the characteristics of Good.

Follow up:

We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain a Good rating.

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

We inspected this service on 13 July 2016. The inspection was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the locations office to see us.

Angels Home Care (Kent) Ltd is a small family run domiciliary care service which provides personal care and support for adults in their own homes. The agency provides care for people in the local Aylesford area together with Sevenoaks, Borough Green, West Malling, Snodland and surrounding areas. At the time of our inspection they were supporting approximately 100 people with personal care tasks.

There was a registered manager in place. 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.

People received a service that was safe. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. The safety of staff who were working out in the community had been assessed with systems put into place to reduce the risk to staff. Risks to people’s safety had been assessed and recorded with measures put into place to manage any hazards identified.

People received support and assistance from enough staff to fulfil their expected care packages and meet their assessed needs. Staff had received the training they required to meet people’s needs. Staff had a clear understanding of their roles and people’s needs. Staff were supported in their role by the management team.

Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support. However, some staff files did not contain information which confirmed their identity. We have made a recommendation about this.

Where staff were involved in assisting to managing people’s medicines, they did so safely. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

People using the service were treated with kindness and compassion by staff who understood the importance of promoting peoples independence. People were treated with dignity and respect. Staff understood the principles of the Mental Capacity Act 2005 and people said they were always asked their consent before any care or support tasks were carried out.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff within people’s homes about how to provide all areas of the care and support people needed.

People were supported to remain as healthy as possible by staff who understood the importance of maintaining people’s nutrition and hydration. Staff supported people to communicate with the relevant health care professionals.

Systems were in place for monitoring the quality and safety of the service and assessing people’s experiences. These included spot checks, annual questionnaires and weekly visits from a member of the management team.

The inspection was carried out by one inspector over a period of one and a quarter hours. We visited the office for the service and reviewed records relating to the recruitment of staff. We spoke with three staff members including the manager of the service. This report is based on our findings during this inspection.

During this inspection we set out to answer one key question; is the service safe?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that appropriate processes were in place to ensure that staff who were recruited to work at Angels Home Care (Kent) Limited were suitable to work with people who may be vulnerable. Staff had provided proof of identity and all staff had completed Disclosure and Barring Service (DBS) checks to ensure that they did not have convictions or cautions that may have indicated that they were not suitable for working with vulnerable people.

The inspection was carried out over a period of five hours by one inspector. There were 71 people receiving a service on the day of inspection. They had a range of needs including difficulties with mobility and communication. Some of the people had dementia. This meant they were not always able to tell us about their experiences.

This report is based on our observations during the inspection, talking with six people who used the service, three relatives and five staff members. We spoke with the manager and reviewed records.

During this inspection we set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff told us that they understood their responsibilities for reporting concerns and we saw that appropriate training and guidance was in place to ensure that people were protected from harm. The safeguarding policy was detailed and provided suitable guidance for staff concerning how to protect people from risk of harm.

Some of the processes for the recruitment of staff to work at the service were not effective in ensuring that all of the checks that are required had been carried out. Not all staff members had provided a full employment history and documents verifying the identity of staff were not always in place.

Is the service effective?

We saw that people’s needs were assessed and daily notes showed that care had been delivered to meet their documented care needs. Staff we spoke with understood people’s care needs and demonstrated that they knew how to meet people’s needs and what to do if they noticed any changes or concerns. When appropriate, other professionals were involved in the care and treatment of people who used the service.

Is the service caring?

We received positive feedback from people who used the service and relatives. They told us that staff were friendly, polite and tidy.

People who used the service were involved in assessing their needs and developing their care plan. Care was delivered in line with the care plan. When additional support was needed the service was flexible. For example, if a person needed urgent additional care or they needed to change their visit times this was responded to.

Is the service responsive?

We found that the manager of the service addressed people's concerns as soon as they were noted. One person who used the service told us “I can phone the office any time”. Another person said “The manager is lovely and runs it well” and the manager “Will listen to what I have to say”.

The service had a business continuity plan which detailed how it would operate during an emergency including in adverse weather.

Is the service well-led?

Staff we spoke with told us that the manager of the service was approachable. They told us they were able to seek advice and guidance whenever it was required, this included out of hours.

We looked at the way the quality of the service was assessed and monitored. We found that a number of spot checks were carried out to ensure that appropriate standards of care were maintained, people’s care plans and risk assessments were reviewed regularly. People had opportunities to make their views known.

People told us they were happy and were satisfied with all aspects of the service. They said, "I get the right amount of time." “They’re very good, they always make sure I’m comfortable, make you feel at ease.” "They meet my needs” and “I find them very helpful and I’m very pleased, they do their job well.” and "Everything they do is 100%".

People were asked for their consent before care was given.

People received care and support that was well planned and sensitively delivered.

People received care in their own homes. This was organised from an office that was suitably equipped and easily accessible to people who used the service.

Robust recruitment procedures ensured that people were supported by suitable staff.

Effective quality assurance procedures ensured that people were provided with a good service.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance with all the standards we inspected.

We obtained people’s views by speaking with five people that used the service and reading recent questionnaire responses and comments that the agency had received.

We saw that people’s responses contained positive comments that included “They always treated him with respect and dignity and we will always be grateful to you”, “Everyone of them was kind, courteous professional and excellent at their job. They treated X with respect and dignity”, “Angels are good” and “Always a cheery smile from you all”.

The agency's quality monitoring survey included questions about different aspects of care. The people who responded had replied positively to all questions.