Domiciliary Care Agency Kent & Sussex

Updated 13 July 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 15 ‘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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post. One registered manager oversaw the Kent services and the other oversaw the Sussex services.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to gain consent from people to visit them in their homes. We also needed to ensure that the provider or registered manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited 4 houses in Kent and 6 houses in Sussex. We spoke to 12 people who lived there about their experience of the care provided. We also spoke to 7 relatives. We spoke with 21 members of staff including both registered managers, home managers and support staff. We reviewed a range of records including 6 peoples care and support plans and medication records. We also reviewed a range of documents relating to the running of the service, this included audits and 3 staff files.

Updated 13 July 2023

About the service

Domiciliary Care Agency Kent and Sussex is a service that provides personal care and support to adults living in 'supported living' settings, so that they can live as independently as possible. This supported living service meets the needs of people with a learning disability and autistic people, people with mental health needs, and people who have a physical disability. Not everybody using the service received the Regulated activity of personal care. At the time of this inspection there were 47 people receiving personal care across 15 homes. 8 homes were situated in Kent and 7 were situated in Sussex. The service is run from an office in Margate in Kent.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People had not always been supported to feel safe in their own home. The concerns were being addressed by the registered manager. People who had been prescribed ‘as required’ medicines were not always well managed. For example, one person was regularly being administered a sedative which was an ‘as required’ medicine. One of the supported living homes did not always have enough staff to support people in line with their care and support plans. The registered manager was reviewing the staffing levels at this home. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. 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.

Right Care: People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People and their relatives told us that staff were kind. During the inspection we observed caring interactions between people and staff. Staff were patient with people when they were communicating.

Right Culture: Staff had not always received the relevant training to support people. For example, a number of staff had not completed positive behaviour support training to support people who could display anxious and distressed behaviours, where this was an identified need. However, we spoke to staff who knew how to support people in line with their care plan. People and those important to them, including advocates, were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views.

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

Rating at last inspection

This is a new rating for this service due to change of address and merge of services. The last rating for the service at the previous premises was Good, published on (published 23 August 2022). The merged Sussex services were previously rated Inadequate (published 24 February 2023).

Why we inspected

The inspection was prompted in part due to information we held about the service from the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ‘Domiciliary Care Agency Kent and Sussex’ and ‘Dyke Road Community support services’ on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.