Background to this inspection
Updated
19 September 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. 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 Care Act 2014.
Inspection team
The inspection team consisted of one inspector and one assistant inspector
Service and service type
London & South East Domiciliary Care is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.
The service was managed by team leaders and care staff, with oversight by two registered managers and one regional manager. The two managers were 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 48 hours’ notice of the inspection because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
The inspection site visit activity started on 26 June 2019 and ended on 19 July 2019. This included visiting the office location on 28 June 2019 and 01 July 2019 and people in their own homes on 03 July 2019.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
We spoke with seven people who used the service and gained feedback about their experience of the care provided. People used a range of different communication methods including vocal and body language. We spoke with three team leaders, eight care staff members as well as the two registered managers and the regional manager.
We reviewed a range of records. This included eleven people’s care files and medicine records. We looked at eleven staff files in relation to recruitment, supervision and training, and a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance questionnaires and spoke with five relatives and one health care professional.
Updated
19 September 2019
About the service
London & South East Domiciliary Care is part of Heritage Care. The service provides personal care to people living in their own home on a 24-hour basis.
At the time of inspection, the service provided care for people living in shared accommodation in Brighton & Hove and three London Boroughs. People lived in local authority and private housing, with some being purpose-built and divided into flats. Each flat or house provided living accommodation for one person to five people. At the time of inspection, the service was caring for 37 people.
People’s experience of using this service and what we found
The service supported people with a learning disability, autism and complex health needs. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Relatives of the people using the service were happy with the care being received. One relative told us, “I can’t fault them, they [relative] are happy, the staff know their [relative's] ways.” Another said, “In three years, [relative] has come on leaps and bounds, they are more independent because of the input by the care staff.”
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.
Care plans were holistic and written in large print with pictures in an easy read format, enabling the person to contribute to their plan of care.
The service followed safe staff recruitment processes. Staff were appropriately trained to meet the needs of the people using the service including safe handling of medicines. Systems were in place to monitor safe delivery of care through audits, observational supervision and senior management oversight.
The service worked in collaboration with health and social care professionals and across several local authorities to provide joined-up care. A complaints process was in place and people knew who to go to if they were unhappy with the service.
People were encouraged to be involved in activities within the local communities and these were person-centred. Some people attended local colleges, undertook voluntary jobs, attended places of worship, as well as a variety of local activities. Music and dance were appreciated by many of the people using the service and some people had performed with professional theatre and ballet companies.
People were supported to shop for groceries and healthy eating was encouraged. At some of the houses, meal times provided an opportunity to meet up and prepare, cook and eat together. The varied abilities of the people using the service were understood by staff, and people were assisted to reach their full potential. We observed the promotion of equality and diversity and staff treating people in a respectful and dignified manner.
Information about some people's end of life wishes had been recorded. However, staff may not be able to support someone at the end of their life as training had not been provided.
We have made recommendations that the provider sources end of life training for staff.
The service was well led by an experienced management team. Quality assurance practices were in place to monitor the service to ensure it delivered high quality care to people.
Rating at last inspection: The last rating for this service was Good (published 22 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up: we will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk