Hertfordshire Domiciliary Care Agency

Updated 25 June 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:

One inspector carried out the inspection.

Service and service type:

Royal Mencap Society - Unit 7 Sundon Business Park (Luton DC) is a domiciliary care service. The service provides care and support to people living within 16 supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Royal Mencap Society - Unit 7 Sundon Business Park (Luton DC) receives regulated activity; 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 two managers 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.

Notice of inspection:

We gave the service three days’ notice of the inspection to make sure the registered managers would be in to support the inspection. This was because they were often out, supporting staff in the various supported living settings. We also needed to plan visits to some supported living settings so that we could speak people using the service and staff.

Inspection activity started on 16 May 2019, when we visited the service’s office to see the managers; and to review records, and policies and procedures. We also visited two supported living settings to speak with people and care staff. We visited three further supported living settings on 17 May 2019. The inspection ended on 28 May 2019 when we had spoken with some people’s relatives by telephone.

What we did:

Before the inspection, we looked at information we held about the service to help us plan the inspection. This included information shared with us by the local authorities and notifications. A notification is information about events that registered persons are required to tell us about. We also reviewed information we received in the Provider Information Return (PIR). This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection, we looked at various information including:

Care records for five people and medicines records for one person.

Records of accidents and incidents; compliments and complaints; audits; surveys.

Three staff files to check the provider's staff recruitment, training and supervision processes.

Some of the provider’s policies and procedures.

We spoke with eight people, three relatives, four care staff, one supported living setting manager, one assistant manager, and the two registered managers [managers].

Updated 25 June 2019

About the service:

Royal Mencap Society - Unit 7 Sundon Business Park (Luton DC) is a domiciliary care service. It provides care and support to people with learning disabilities or autistic spectrum conditions, living in 16 supported living settings spread across Bedfordshire, Buckinghamshire and Hertfordshire. At the time of the inspection, 44 people were being supported with personal care.

People’s experience of using this service:

People’s support focused on them having as many opportunities as possible to gain new skills and become more independent. This supported the principles of ‘Registering the Right Support’ and other best practice guidance. These ensured that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People were particularly proud that they had been supported to register to vote and they were looking forward to exercising this right in future elections.

People were protected from harm by staff who were confident in recognising and reporting concerns. People were safe because potential risks to their health and wellbeing had been managed well. There were enough staff to support people safely and to enable them to take part in a range of activities they enjoyed. People were supported well to take their medicines. Lessons were learnt from incidents to prevent recurrence. Staff followed effective processes to prevent the spread of infections.

Staff had the right skills to meet people's needs effectively. Staff were well supported and had information to meet people’s assessed needs. People had enough to eat and drink and were supported to make healthy food choices. People had access to healthcare services when required. This helped people to maintain their health and well-being.

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. People were fully involved in making decisions about their care and support. People were involved in planning and reviewing care plans. Staff supported people in a way that respected and promoted their privacy and dignity. They encouraged people to be as independent as possible.

People were happy with how staff supported them to meet their individual needs. They said this had been done in a kind and person-centred way. Complaints were managed well and there was learning from these to reduce the risk of recurrence. The service did not currently provide end of life care, but they had including some information in people’s care plans. They would do more to further improve on the quality of this information.

Audits and quality monitoring checks were carried out regularly to continually improve the service. The provider had systems to enable people, relatives and staff to provide feedback about the service. People's experiences of the service were positive. Staff felt fully involved in ensuring the service met its regulatory requirements.

Rating at last inspection:

At the last inspection, the service was rated Good (report was published in October 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.