Brothers of Charity Services Merseyside Domiciliary Care

Brothers of Charity Services Merseyside Domiciliary Care is a domiciliary care agency. It provides personal care to people living in their own homes and provides care and support to people living in supported living settings, so that they can live as independently as possible.

The service provides support to adults living with a learning disability or an autistic spectrum disorder.

At the time of the inspection 200 people were using the service. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. 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.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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.

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

The service approach to planning and delivering care and support to people was extremely person centred. People were fully involved in the development of their care plans and without exception people were consistently supported and encouraged to plan and achieve their goals and aspirations. The service was very responsive to people’s needs, wishes and preferences which they agreed to, and this was evidenced in excellent outcomes for people. People’s quality of life had improved significantly, and they developed in their self-confidence independence and their self-esteem.

People were protected from the risk of abuse and harm. People were supported to take positive risks as part of an independent lifestyle. The recruitment of staff was safe, and people were involved in the recruitment process. People supported by the right amount of suitably skilled and experienced staff. Medicines were used safely, and people were supported to be as independent as possible with managing their own medicines. Accidents and incidents were reported in an open and transparent way and lessons were learnt to help reduce further occurrences.

People's needs had been thoroughly assessed and detailed support plans were developed with clear guidance for staff on how to meet people’s need and choices. Staff received the training and support they needed to meet people’s needs and carry out their role effectively. People received good support with their dietary and healthcare needs and they were supported to lead active and healthy lifestyles.

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.

People were treated with kindness and respect and their independence was encouraged and promoted. People’s right to privacy was respected, they told us staff were respectful of their homes. People were given many opportunities to express their views and opinions and they felt listened to.

The leadership of the service promoted a positive culture that was person-centred and inclusive. People were supported to achieve their goals and aspirations with positive outcomes. The registered manager was supportive and approachable and led by example. The service worked well with other professionals and organisations in meeting people's needs. Effective systems were in place to check on the quality and safety of the service and for making improvements.

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

Rating at last inspection

The last rating for this service was Good (published 01 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Merseyside Domiciliary Care service is part of the Brothers of Charity organisation and provides personal care and support to people living in their own homes. At the time of this inspection the service was supporting nine people living in two properties within the grounds of Thingwall Hall.

A registered manager was in post. 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 are 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.

People are protected from abuse as the registered provider had developed robust procedures in relation to safeguarding people. Staff had received training in safeguarding people are knew who they needed to contact to report any concerns they had.

Systems were in place to identify, assess and plan for known risks to people. Clear guidance was available to staff as to how they assessed risk with people. Regular monitoring took place of risk associated information to ensure that it was up to date and remained effective.

Safe staff recruitment procedures were in place. The process involved obtaining references and carrying out checks to help ensure that only staff suitable to work with vulnerable people were employed.

Robust training was available to staff. This helped ensure that people were supported by staff who knew current best practice in delivering care and support safely.

People healthcare needs were assessed and planned for. This meant that people received the appropriate medical support when they needed it.

People were involved in shopping for food and planning their meals with the support of staff who knew and understood their likes, dislikes and personal preferences.

The registered manager and staff had a detailed knowledge of people’s rights to decision making under the Mental Capacity Act 2005.

People had access to a robust complaints procedure. People knew who to speak to if they were not happy.

People’s differing communication needs had been considered by the service. Documents relating to people’s care and support, along with meeting minutes and procedures had been published in large print with the use of symbols and pictures.

People had detailed care and support plans in place that were available to staff. This helped ensure that staff were aware of how people wanted to be supported.

Procedures were in place for the safe management of people’s medicines. This helped to ensure that people received the support they required with their medicines.

Positive relationships had been formed between people and staff. It was evident that they knew each other well. This helped ensure that people received the care and support how they wished.

People were asked for their opinions of the service during regular meeting and by completing survey forms. This demonstrated that people’s views were considered when planning changes to the service.

Robust systems were in place to regularly check on the quality of the service delivered to people and that when required, improvements were made. These checks included daily, weekly and monthly audits.

We were able to speak individually with two of the people using the service who told us they were happy with the support provided by Thingwall. Some comments made were "If I have a problem I know who to tell'; 'I can get what I need' and 'I like the staff'.

We found they were treated respectfully, given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do.

Systems were in place to offer protection to the people who use the service from abuse and people spoken with confirmed that they felt safe and had no concerns regarding the care provided.

The people who accessed the service provided by Thingwall were cared for by staff that were appropriately recruited, well trained and experienced at supporting them.

No complaints, concerns or allegations were received from the people using the

service during our visit and the provider confirmed that they had not received any formal complaints in the past 12 months.

'We're very satisfied with all the care'.

'We are all happy with the current situation'.

'We cannot overestimate the attention given to my brother'.

We found people were treated respectfully, given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do. The people who accessed the service provided by Thingwall were cared for by staff that were appropriately recruited, well trained and experienced at supporting them. The organisation monitored the quality of the service provided on a regular basis.