Kingwood - Domiciliary Care

Updated 24 March 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 28 February and 6 March 2018. It was announced and was carried out by one inspector. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. Prior to the inspection we looked at the PIR and all the information we had collected about the service. This included previous inspection reports, information received and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.

During the inspection we spoke with three people who use the service and received feedback from five relatives. We also spoke with the registered manager, the chief executive officer, the two regional directors, the head of human resources and area managers. We spoke with support workers and observed interactions between people who use the service and staff during the two days of our inspection. As part of the inspection we requested feedback from seven community professionals and received a response from one. We received additional feedback from 32 members of the care staff team in the form of completed questionnaires.

We looked at five people's care plans, daily notes, monitoring records and medication sheets. We saw six staff recruitment files, staff training records and the staff supervision and appraisal log. We reviewed a number of other documents relating to the management of the service. For example, some policies, incident forms, staff meeting minutes, compliments and concerns records.

Updated 24 March 2018

Kingwood – Domiciliary Care provides personal care to people living in their own homes so that they can live as independently as possible. They specialise in providing services to people with autistic spectrum disorder, some of whom may also have learning disabilities. At the time of our inspection there were 34 people using the service. Of those, 28 people lived in shared accommodation in supported living facilities and six people lived on their own in the community. The provider, Autism at Kingwood, provides support to a total of 142 people with autism living in the community. However, this inspection and report only relates to the 34 people receiving the regulated activity of personal care. Their care and housing are provided under separate contractual agreements. CQC does not regulate the premises people live in, this inspection only looked at people’s personal care and support. Those receiving support but not receiving personal care are outside the regulatory remit of the Care Quality Commission (CQC).

At our last inspection in November 2015 we rated the service as good overall, with a rating of outstanding in the responsive domain. At this inspection we found the evidence continued to support the same rating and the service continued to meet all the fundamental standards of quality and safety. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This inspection took place on 28 February and 6 March 2018. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

Why the service is rated good:

People benefitted from staff who were trained and had an in depth knowledge and understanding of people with autistic spectrum disorder and the individuals they worked with. Staff used those skills when developing care plans that were highly individualised to each person. The service was responsive and proactive in recognising and adapting to people's changing needs. Staff were innovative in exploring ways to help people overcome their anxieties, learn new skills and lead a more fulfilling life. People and their relatives knew how to raise concerns and confirmed they, or their family member, were listened to and taken seriously if they did.

Staff were positive about the work they did with the people who use the service. The majority of staff who responded to our requests for feedback felt supported by the management and felt the support they received helped them to do their job well. Some staff did not feel confident about reporting concerns or poor practice to their managers. Some also felt their managers did not always deal effectively with concerns they raised. These concerns were passed to the registered manager and plans were being developed to explore and resolve those concerns by the end of our inspection. Quality assurance systems were in place to monitor the quality of care being delivered and the running of the service.

People were protected from abuse and supported to make their own choices. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There were sufficient numbers of staff and staff were trained to handle medicines correctly.

People benefitted from a staff team that was well trained and supervised. Staff had the skills and support needed to deliver care to a good standard. We have made a recommendation that future ongoing staff training be updated in line with the latest best practice guidelines for social care staff.

People were 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 supported this practice. People's health and social care needs were met and they were supported to eat and drink enough. Staff ensured people had food that met their individual preferences and their diverse needs.

People benefitted from a staff team that was caring and respectful. Staff knew each person well and worked with them in a calm, caring and professional way. People's rights to confidentiality, dignity and privacy were respected. They were enabled and encouraged to develop and maintain their independence wherever possible.

Further information can be found in the detailed findings in the full report.