Archived: North Cumbria Domiciliary Support Service (West)

Updated 21 November 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 was planned to check 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 12 & 26 October 2018 and was unannounced on the first day. We arranged visits to people’s homes on the second day with their prior agreement. The inspection was conducted by an adult care inspector.

Before the inspection we reviewed the information we held about the service, such as notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law.

We spoke with three people who used the service and two people’s relatives on the telephone. We visited both houses where supported living arrangement were in place.

We met with three support staff and two senior support staff, two supervisors and the manager. We looked at three staff files and we saw minutes of staff meetings.

We received a copy of the training matrix and the training plan. We saw evidence of training being completed. We also had evidence of recruitment processes. We looked at quality audits and at risk assessments. We saw both internal and external audits.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service, including the information in the PIR, before we visited the service. We also asked the local social work team and local health care providers for information about the service. We had contact with staff from health and the local authority who purchase care on behalf of people. We used a planning tool using this information.

Updated 21 November 2018

This was an unannounced inspection on 12 & 26 October 2018. This was the first inspection of this service since the provider, Cumbria County Council, restructured some of its services.

North Cumbria Domiciliary Support Service (West) provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. Supported was being offered to seven people at the time of the inspection.

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 North Cumbria Domiciliary Support Service (West) 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 a new manager in post who was applying 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. The manager of the service had responsibility for five other supported living houses in Carlisle.

People received the care they needed from care staff who they knew and who knew them well. The staff were friendly, kind and caring and people valued the service they received.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The care staff were well trained and supported to be able to provide the care people needed. Staffing levels were suitable to meet the assessed needs of people in the service. Staff recruitment was thorough with all checks completed before new staff had access to vulnerable people. The organisation had robust disciplinary procedures in place.

People were protected against the risk of abuse or avoidable harm. Risk assessments were in place to protect people from risks but also enabled them to safely carry on their day to day lives. The care staff took prompt and appropriate action if they were concerned that a person was at risk.

Each person had a detailed and up to date support plan. People were central in planning and agreeing to the care they received. People could ask for changes to their planned care and the service agreed to these where possible.

We have made a recommendation about the use of technology to aid people’s communication needs.

The service had developed good links with healthcare and social care professionals to support people with their health and well-being. Medicines were handled safely and people received support with their medicines as they needed. People received the support they needed to prepare meals and drinks.

The manager was knowledgeable about the Mental Capacity Act 2005 and responsibility to protect the rights of people who could not make or express their own decisions. The service demonstrated that they were aware of people's capacity and documented this in people's written records of care.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff and people who received support were satisfied with the way the service was led and with the culture promoted by management. People who used the services said they were involved and their opinions taken into account. Complaints were managed correctly.

We found there were effective systems in place to monitor the quality of the service provided to people which ensured good governance. The service operated from a separate office base which had good IT and telephone systems.

The culture of the service was positive, person centred, forward thinking and inclusive. There was a strong ethos centred on effective partnership and excellent working relationships had been forged with other community health and social care professionals.