SilverBirch Healthcare Ltd

St Mary Cray is a domiciliary care agency. It provides personal care and support to people in their own homes. Not everyone using the service may receive the regulated activity; personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had 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.

There were policies and procedures in place to safeguard people from possible harm or abuse and staff were aware of the action to take if they had any concerns. Risks to people's health and well-being were identified, assessed and reviewed on a regular basis to ensure people's safety. There were systems in place for the monitoring, investigating and learning from incidents and accidents. People received their care on time and care staff stayed the required amount of time to ensure people were safe and their needs were met. There were safe robust staff recruitment practices in place to ensure staff were suitable to be employed in a social care environment. There were systems in place which ensured medicines were managed and administered safely by staff where required. At the time of our inspection there was no one using the service that required support with administering their medicines. There were systems in place to manage emergencies and to reduce the risk of infection.

Staff new to the service were provided with an in-depth induction into the service and their role. Staff told us they felt supported to do their job and received regular training, supervision and annual appraisals of their work performance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff work together to ensure that people receive consistent, coordinated and person-centred care and support. People were supported to meet their nutrition and hydration needs and had access to health and social care professionals when required.

People told us they were consulted about their care and support needs and were provided with information that met their needs to help support decision making. People told us staff treated them with respect, their independence was encouraged and their privacy and dignity was maintained at all times. The service involved people and treated them with compassion and kindness. People received personalised care that

met their needs and wishes. Care plans and assessments considered the support people required with regard to any protected characteristics they had under the Equality Act 2010. Assessments allowed for people to document any end of life and palliative care needs and wishes they had, should they so wish. Staff we spoke with told us they felt the service was very responsive to people's needs and they worked closely with health and social care professionals to ensure people's needs were appropriately met. People told us they were aware of the provider's complaints procedure and would raise any concerns if they needed to.

People spoke very positively about the staff that supported them and how well they thought the service was managed. Staff told us they felt very well supported by the registered manager, they received good training and the registered manager was always available to them day and night offering guidance when they needed it. There were effective leadership and communication systems within the service and staff told us they regularly attended supervision, training and team meetings within the office. Systems in place ensured the registered manager and provider took account of the views of people using the service, their relatives and staff. There were effective systems in place to regularly assess and monitor the quality of the service that people received. The service worked well with external organisations, health and social care professionals and the local community to ensure people's needs were safely met and to help improve the quality of the service provided.

The five questions we ask about services and what we found