Domiciliary Care Dorset

Updated 17 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 and 12 March 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff . We needed to be sure that they would be in. The inspection was undertaken by one inspector.

Prior to the inspection we reviewed the information we held about the service, including statutory notifications submitted about key events that occurred at the service. We did not request a Provider Information Return (PIR) prior to our inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We gathered this information during the inspection. We obtained the views of the service from the local commissioners prior to our inspection.

During the inspection we spoke with four members of staff, the registered manager and the locality manager. We spoke with two people and three relatives about their views on the quality of the care and support being provided. We also spoke with three health and social care professionals.

We looked at care documentation relating to four people, three people’s medicines administration records, three staff personnel files, staff training records and records relating to the management of the service including quality audits.

Updated 17 May 2018

This inspection took place on 8 and 12 March 2018 and was announced. The inspection was undertaken by one inspector.

This service provides care and support to people living in four 'supported living' settings, so that they can live in their own home as independently as possible and one person in their own home in the community . People's care and housing are provided under separate contractual agreements. People shared their homes with volunteer support workers called co-workers. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. There were 13 people being supported by this service at the time of the inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other best practice guidance. These values include choice, promotion of independence and inclusion.

Not everyone living in the supported living services received the regulated activity personal care. 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.

There was a registered manager in place. 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.

People were safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks for the majority of people were assessed and monitored regularly.

Staff understood how to prevent and manage behaviours that the service may find challenging.

Staffing levels ensured that people's care and support needs were continued to be met safely and safe recruitment processes continued to be in place.

Staff understood the Mental Capacity Act 2005 and how to support people's best interest if they lacked capacity. However assessments were not recorded. We have made a recommendation about the recording of mental capacity assessments and best interest decisions in line with the Mental Capacity Act 2005.

People's needs and choices continued to be assessed and care provided to meet their needs. They received care from staff that had received training and support to carry out their roles.

There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff continued to support people to book and attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.

Medicines were managed safely.

Staff were caring and compassionate. People were treated with dignity and respect and staff ensured their privacy was maintained. People were encouraged to make decisions about how their care was provided.

Staff had a good understanding of people's needs and preferences.

The provider was aware of some people's end of life wishes. We have made a recommendation about supporting people to express their end of life wishes.

People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement. However some improvements were required to responding to feedback from surveys from people that use the service.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. We have made a recommendation about the recording of audits and checks undertaken.