7 May 2018
During a routine inspection
The DOVE project is a domiciliary care agency that provides personal care and support to people with a learning disability or a mental health condition in their own homes. At the time of our inspection the service was providing a 24 hour supported living service and personal care to three people. A supported living service is one where people live in their own home and receive care and support to enable them to live independently without total reliance on parents or guardians. People have tenancy agreements with a landlord and receive their care and support from a domiciliary care agency. As the housing and care arrangements are separate, people can choose to change their care provider and remain living in the same house.
The service is required to have a registered manager and at the time of our inspection a registered manager was not in post. However, the manager who was in overall charge of the day-to-day running of the service had started the process to make an application to the Care Quality Commission (CQC) to become the registered manager. 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 was a positive culture in the service, the management team provided strong leadership and led by example. Management were visible and known to staff and all the people using the service. Staff were consistently positive about the local management of the service. Comments included, “There is a lovely person centred management approach to working with staff and clients. I don't feel afraid to take any issues or problems to them. There are no reprisals. This company at local level are amazing at valuing their staff.”
Staff told us they were well supported and confident in their abilities to fulfil their roles and responsibilities. Staff roles and responsibilities were clearly defined and understood by all. Staff commented, “ In the short time I’ve been working with Dove I have received all necessary training and been correctly inducted and shown the ropes with every client I support. One of the best companies I have worked for.”
People using the service had limited verbal communication and were not able to tell us their views about the care and support they received. However, we observed people were relaxed and comfortable with staff, and they received care and support in a way that kept them safe. People had a good relationship with staff and were comfortable with the staff that supported them.
People’s behaviour and body language showed that they felt really cared for and that they mattered. A health care professional commented, “Each of Doves clients appear to be happy and safe both at home and out and about with their staff members. This is evidenced by their now calm demeanours and change in behaviour from the aggression and frustration that they had displayed in the past.” A relative told us, “I’m very happy with the way things are being handled. I have not had a reason to have concerns with the service.”
Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. People were supported by dedicated staff teams who were employed to work with specific people using the service.
People received care from staff that knew them well, and had the knowledge and skills to meet their needs. Staff spoke about the people they supported fondly and displayed pride in people’s accomplishments and showed a willingness to support people to be as independent as possible.
Staff supported people to maintain a healthy lifestyle where this was part of their support plan. People were supported by staff with their food shopping and with the preparation and cooking of their meals.
People were supported to have their medicines as prescribed. Systems for recording when people had received their medicines were robust.
People were supported to access the local community and they took part in activities that they enjoyed and wanted to do. Records showed that people went out most days for walks, shopping and visiting local attractions.
The management and staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. People are 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 support this practice. DoLS applications or authorisations were in place for people who required this. Where relevant best interest processes had been followed to help ensure any restrictive practices were necessary and proportionate.
Relatives said they knew how to make a formal complaint if they needed to but felt that issues would be resolved informally as the management and staff were very approachable. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.
There was effective quality assurance systems in place to monitor the standards of the care provided. Audits were carried out regularly by the manager and staff. Relatives and people’s view about how the service was operated were sought.