Background to this inspection
Updated
2 July 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by a single inspector and an Expert by Experience. An Expert by Experience is a person who has had experience of the relevant care setting, in this instance experience of services for people living with a learning disability.
Service and service type:
This was a domiciliary care service. It provides personal care to people living in their own homes in the community.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. On the day of inspection, the registered manager was unavailable. We spoke with the registered manager by telephone following our inspection.
Notice of inspection:
This was a planned comprehensive inspection and was announced. We inspected the service on 16 April 2019.
What we did:
Prior to the inspection we examined information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about.
The provider had completed a Provider Information Return.This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection we spoke with two people who used the service, two relatives, five members of care staff, two service managers and an area manager. We also looked at five care records in detail and records that related to how the service was managed including staffing, training, medicines and quality assurance.
Updated
2 July 2019
About the service: This service is a domiciliary care agency. It provides personal care to 50 people living in their own houses and flats. It also provides other support to people living with a learning disability. As the Care Quality Commission (CQC) does not regulate domestic support, this inspection relates only to people receiving the regulated activity of personal care.
The service had been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.
People’s experience of using this service: The service was exceptional in placing people at the heart of the service and its values. It had a strong person centred and local community-based ethos. Staff and the service's management told us how they were passionate about providing outstanding person-centred care to people when they needed it.
People's needs, and wishes were met by staff who knew them well. We saw and were told of many examples of staff going 'above and beyond' to help and support people they cared for.
There was a system in place to carry out quality checks. These had been carried out on a regular basis. People were asked their views in person and via questionnaires.
Medicines were managed safely. Arrangements were in place to monitor and manage medicines.
We saw evidence of caring relationships in place, and a clear commitment to support people at difficult times with compassion, respect and affection. People said they felt safe. There was enough staff to support people and staff were flexible in their approach. Efforts were made to ensure people had the same care staff visiting.
People were supported to have nutritious meals according to their likes and dislikes and their dietary needs had been catered for. This information was detailed in people’s care plans. Staff followed guidance provided to manage people's nutrition.
Care plans contained information about people and their care needs.
Staff had received training to support their role. Staff had received regular supervision and appraisal.
People had good health care support from professionals. The provider and staff worked in partnership with health and care professionals.
Staff were aware of people's life history and preferences and they used this information to develop positive relationships and deliver person centred care. People felt well cared for by staff who treated them with respect and dignity.
People were supported to access a range of leisure pursuits and participate in the community they lived in.
Although the provider was not responsible for the environments which people lived in they had put in place arrangements to work with the housing providers to ensure they met people’s needs.
Arrangements were in place to manage and prevent cross infection and ensure good infection control systems were in place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provided had displayed the latest rating on the website. When required notifications had been completed to inform us of events and incidents.
More information is in the detailed findings below.
Rating at last inspection: Good (Report Published January 2016).
Why we inspected: This inspection was carried out based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect sooner.
Please see the ‘action we have asked the provider to take’ section at the end of this report.