About the service:

Hamilton House (also known as Bluebird Care (Medway), is a domiciliary care agency registered to provide personal care for people who require support in their own home. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service was supporting 80 people. They provide care services mainly to people living in the Medway local authority area, but also to some people who live in the Kent local authority area.

People’s experience of using this service:

People told us they felt safe with staff.

People had good relationships with staff, who were knowledgeable of their physical and emotional needs, as well as likes, dislikes and interests. Staff were responsive to changes in people's health needs. If needed, they sought advice from relevant professionals.

People felt included in planning their care. People’s rights and their dignity and privacy were respected.

People were supported to live the lifestyle of their choice. People told us they were listened to by the management of the service.

People could involve relatives and others who were important to them when they chose the care they wanted.

People received a person-centred service that met their needs and helped them to achieve their goals and ambitions. People were encouraged to be as independent as possible.

People were fully involved in their care planning and received information in a way that they understood. The care plans were consistently reviewed and updated. Care planning informed staff what people could do independently and what staff needed to do to support people.

Staff supported people to maintain a balanced diet and monitor their nutritional health. People had access to GP’s and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.

People were protected from the spread of infection and medicines were stored and managed safely. There were polices and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People felt comfortable raising any complaints with staff and the registered manager.

People were asked for feedback about the service they received.

People found the registered manager approachable and supportive.

The registered manager recruited staff with relevant experience and the right attitude to work with people. New staff were given an induction and on-going training. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs.

The provider who was also the registered manager made sure they monitored the service in various ways to ensure they continued to provide a good quality service that maintained people’s safety.

The registered manager and staff were working with a clear vision for the service.

More information is in the detailed findings below.

Rating at last inspection: This service was rated, “Good” at the last inspection on 19 and 21 April 2016.

Why we inspected: This was a planned comprehensive inspection to check the service remained Good. We found 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.

We inspected the service on 19 and 21 April 2016. The inspection was announced.

Hamilton House is a domiciliary care agency providing personal care to people living in their own homes in the community. They provide services to any people who need care and support. The agency provides care services mainly to people living in the Medway local authority area, but also to some people who live in the Kent local authority area. There were approximately 60 people receiving support to meet their personal care needs on the days we inspected.

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 providers of the service, one of whom was also the registered manager and the other was the principal, were fully involved in the day to day running and management of the service. The registered manager and the principal supported two supervisors who supported two care coordinators and two support supervisors who in turn supported the care staff. An administration staff structure was in place to support the management and care teams using time efficiently for the benefit of people using the service.

People and their relatives told us they felt safe when receiving support from the service. Staff knew their responsibilities in keeping people safe, they had a good understanding of what constitutes abuse and how to safeguard vulnerable adults from abuse. They were clear about the reporting mechanisms for any suspicions they may have and who they could report to outside of Hamilton House if necessary.

The registered manager made sure risks were identified and managed by having risk assessments in place. People had clear individual risk assessments that were easy for staff to follow when supporting each person. Addressing people’s own vulnerable situations and how best to manage risks in their particular circumstances. Environmental risks were identified inside and outside people’s homes, protecting people and staff while support was being provided.

The provider followed safe recruitment procedures to make sure the staff they employed were suitable to carry out their role. Enough staff were available to be able to run an effective service, responsive to people’s needs. Staff had the training and supervision required to be able to perform well in their role. Their personal development needs were identified and supported within a supervision and annual appraisal system. Staff told us they felt supported by the training and the process for one to one supervision and observation.

Not everyone needed support with taking their medicines, and those that did often had family members to take most of the responsibility for their medicines. Where staff were asked to support people with taking medicines, safe processes were in place to safeguard people and staff.

People or their family members would usually contact health care professionals for appointments and advice. When this was not the case, staff supported people with their health care needs. When staff had concerns about a person they reported to senior members of staff for support and advice.

People and their relatives were clear that staff were very good and had a kind and caring approach. Staff told us how they loved their job and enjoyed having good conversations with people. People and their family members were involved in assessing and planning their support, having the opportunity to say how they liked things done and to change things when they wished. Staff knew how important it was to treat people with dignity and respect, and gave examples of this. Confidentiality was understood by staff and all records were stored securely, making sure people’s privacy was respe