Blossoms Care Services Ltd DCA

At the last Care Quality Commission (CQC) comprehensive inspection on 19 and 20 January 2016, this service had an overall rating of Good.

At this inspection, we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Blossoms Care Service Ltd DCA, on our website at www.cqc.org.uk

This service is a domiciliary care agency. Blossoms Care Services is a care agency that provides care services to people in their own homes and people living in supported living accommodation. Not everyone using the service receives a regulated activity of 'personal care.' CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and administration of medicines. At the time of the inspection the service was providing support to 68 people, in the Isle of Sheppey, Sittingbourne, Faversham and the Swale area. The service can provide a range of visits to people, from one to two hours per week, up to several visits per day. Support is primarily given to older people, people with learning disabilities, people with sensory impairment, and people with mental health difficulties. People had a variety of complex needs including mental and physical health needs and behaviours that may challenge. The support provided aims to enable people to live as independently as possible.

Staff enabled people to use assistive technology to support people to be as independent as possible. They had initiated and led projects to help people move from residential services, where they had previously required constant staff supervision, to allow them more privacy and independence in their own homes or supported living services. Staff were available and easily accessible nearby. Staff and the management team had an understanding of managing risks and had supported people that had previously challenged services to reach their full potential.

There was a registered manager 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 and associated Regulations about how the service is run.

The service provided care and support to people enabling them to live fulfilled and meaningful lives. Staff were skilled at ensuring people were safe whilst encouraging them to reach their potential and live independent lives. People and their relatives were overwhelmingly positive about the service they received. One person said, "The carers are ok, nice and they do help me. They support me and are helping me to maintain my independence. I am working towards getting my own house and recently staff have started

helping me to take my own medicines".

The service continued to have suitable processes in place to safeguard people from different forms of abuse. Staff had been trained in safeguarding people and in the agency's whistleblowing policy. Staff were confident that they could raise any matters of concern with the provider, the registered manager, the managers of services or the local authority safeguarding team. Staff were trained in how to respond in an emergency (such as a fire, or if the person collapsed) to protect people from harm.

Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff understood the processes to follow and knew who to contact, if they felt a person's normal freedoms and rights were being significantly restricted.

The management team involved people in planning their care by assessing their needs on their first visit to the person, and then by asking people if they were happy with the care they received. There was a strong emphasis on person centred care. People were supported to plan their support and they received a service that was based on their personal needs and wishes. The service was flexible and responded positively to changes in people's needs. People could express their opinions and views and they were encouraged and supported to have their voices heard within their local and wider community.

The management team carried out risk assessments when they visited people for the first time. Other assessments identified people's specific health and care needs, their mental health needs, medicines management, and any equipment needed. Some people were supported by their family members to discuss their care needs, if this was their choice to do so.

People were supported with meal planning, preparation and eating and drinking. Staff supported people, by contacting the office to alert the management team about any identified health needs so that their doctor or nurse could be informed.

People had positive relationships with the support staff who knew them well and used their shared interests to help people live interesting lives. There were enough staff available to meet people's needs and people were busy and engaged with their communities. They were supported to make and maintain friendships and relationships that were important to them.

The service had robust recruitment practices in place. All new staff received induction training and they worked alongside experienced staff and had their competency assessed before they could work on their own. Refresher training was provided at regular intervals. Staff had been trained to administer medicines safely.

Staff followed an up to date medicines policy issued by the provider and they were checked against this by the training manager. Staff were trained to meet people's needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

People said that they knew they could contact the management team at any time, and they felt confident about raising any concerns or other issues. The management team carried out spot checks to assess care staff's work and procedures, with people's prior agreement. This enabled people to get to know the managers of the services.

The provider had processes in place to monitor the delivery of the service. As well as talking to the management team at spot checks, people could phone the office at any time, or speak to the senior person

on duty for out of hours calls. People's views were obtained through meetings with the person and meetings with families of people who used the service. The provider checked how well people felt the service was meeting their needs.

Incidents and accidents were recorded and checked by the provider or registered manager to see what steps could be taken to prevent these happening again. Risks were assessed and the steps taken to minimise them were understood by staff. Managers of services ensured that they had planned for foreseeable emergencies, so that should they happen, people's care needs would continue to be met.

People felt that the service was well led. The provider and registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the range of services provided. Staff were motivated and proud of the service. The service had developed and sustained effective links with organisations that helped them develop best practice in the service. The registered manager used effective systems to continually monitor the quality of the service and ongoing plans for improving the services people received.

The five questions we ask about services and what we found