Expertise Homecare (Central & West Kent) Ltd was rated Good overall at its January 2017 inspection, with an Outstanding rating for responsiveness driven by innovative use of proprietary software, a customer portal, and a proactive hospital-discharge initiative. No regulatory breaches or failure themes were identified.
Strengths
· Provider developed an innovative online software system stored on encrypted electronic tablets enabling staff to access care plans, risk assessments, medicines management and rotas in the field.
· Registered manager purchased a minibus and deployed a dedicated team to a hard-to-reach area in Kent, enabling hospital discharge for multiple people who would otherwise have remained in hospital.
· Customer and relative portal accessible from anywhere in the world allowed people and families to track visits, view care plans and see which staff were attending.
· Consistent staff allocation through a 'runs' system promoted continuity and enabled people to build relationships with the same carers.
· Comprehensive induction including three days classroom training, a 12-week supervised programme incorporating the Care Certificate, and opportunities for QCF qualifications.
Quality-Statement breakdown (19)
safe: Safeguarding people from abuseGood
safe: Medicines managementGood
safe: Risk assessment and managementGood
safe: Safe recruitmentGood
safe: Staffing levels and business continuityGood
effective: Staff training and inductionGood
effective: Supervision and appraisalGood
effective: Mental Capacity Act and consentGood
effective: Nutrition, hydration and health supportGood
effective: Communication systemsGood
caring: Privacy and dignityGood
caring: Person-centred care and involvement in care planningGood
caring: Consistency and continuity of staffGood
responsive: Innovative use of technology to meet people's wishesOutstanding
responsive: Care planning, assessment and reviewOutstanding
responsive: Complaints handlingGood
well-led: Leadership and cultureGood
well-led: Quality assurance and governanceGood
well-led: Engagement with people, relatives and staffGood
Expertise Homecare (Central & West Kent) Ltd was rated Good across all five key questions at this October 2019 inspection, down from an Outstanding in Responsive at its previous inspection. The main concern was inconsistency of care staff during the registered manager's maternity leave, which had since been substantially addressed through improved recruitment, retention initiatives and the manager's early return.
Concerns (2)
moderateStaffing levels: “"I never know who's coming through the gate and that is sometimes a bit of a worry for me" and "I am mostly happy with them, but they don't have enough consistency in the carers"”
moderatePerson-centred care: “"There is no consistency in the care which does not give her or me confidence in her safety with them."”
Strengths
· Staff treated people with kindness, care and compassion; 100% of survey respondents said they were treated with dignity and respect.
· Registered manager returned early from maternity leave to address concerns, improving staff retention and morale.
· Safe recruitment practices including DBS checks, full work history and references were consistently followed.
· Personalised care plans developed with people and relatives, reviewed regularly to reflect changing needs.
· In-house trainer delivered practical, competency-based training using real equipment mirroring home environments.
Quality-Statement breakdown (24)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough; staff working with other agencies; supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Continuous learning and improving careGood