Background to this inspection
Updated
25 July 2021
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
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. This service also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection visit. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 5 July 2021 and ended on 12 July 2021. We visited A2Dominion Chimney Court on 5 July 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection, including notifications received from the provider. The law requires providers to send us notifications about certain events that happen during the running of a service. We sought feedback from the local authority and professionals who work with the service. We reviewed the provider’s website. The provider was not asked to complete a provider information return prior to this inspection. 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. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.
During the inspection
We spoke with five people who used the service and eight relatives about their experience of the care provided. We spoke with eight staff including the head of care who was the registered manager of the service, another supporting registered manager, a senior care coordinator who managed the Beechwood Grove complex on a day to day basis, a care coordinator and four care staff, which included night staff and newly inducted staff.
We reviewed a range of records. This included six people’s care records, medication records and daily notes. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures, quality assurance audits, accident and incident reports with associated safeguarding and care quality referrals to the local authority.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with six community professionals who engage with the service.
Updated
25 July 2021
About the service
A2 Dominion Care & Support Chimney Court is a domiciliary care agency. Support is provided to people living in Chimney Court, Beechwood Grove, Charles Clore Court and Cornerstones in Reading. Each complex contains individual flats within buildings which are described as extra care housing. The service also supports people living in their individual homes within the Reading area. The service supports people with a range of needs and operates from an office within each of the housing complexes. At the time of the inspection the service was providing personal care to 35 people. Not everyone who used the service received personal care. 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 experience of using this service and what we found
People experienced safe care, protected from avoidable harm by trusted staff, who had completed safeguarding training and knew how to recognise and report abuse. Staff effectively identified and assessed risks to people, which were managed safely. Sufficient suitable staff with the right mix of skills were deployed to deliver care and support to meet people’s needs. Staff underwent a robust recruitment process to assure their suitability to support people living in their own homes, which explored gaps in their employment history and conduct in previous care roles. People received their prescribed medicines safely from staff, in accordance with recognised guidance. Staff consistently demonstrated high standards of hygiene and cleanliness whilst delivering care and support. Staff followed good food safety and hygiene practice when preparing or handling food.
Staff assessed all aspects of people’s physical, emotional and social needs and ensured these were met to achieve good outcomes for them. Staff were supported to develop and maintain the required skills and knowledge to effectively support people. Staff emphasised the importance of eating and drinking well and reflected best practice in how they supported people to maintain a healthy balanced diet. Staff worked together well with community professionals to make sure care and treatment met people’s changing needs. Staff supported people to make choices and collaborated effectively with partners, to ensure specialist or adaptive equipment was made available to enable improved care and support.
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.
Respect for privacy and dignity was at the heart of the service’s culture and values. People experienced caring relationships where staff treated them with kindness and compassion in their day-to-day care. People were supported to make decisions about their care and these choices were respected by staff. Staff encouraged people to maintain and develop their independence, and to direct their own health and care whenever possible.
People experienced personalised care, which consistently achieved good outcomes and had significantly improved the quality and longevity of their lives. People received information in a way they could understand and process, allowing for any sensory impairment. People were enabled to live as full a life as possible and were supported to take part in appropriate activities, which enriched the quality of their lives. People were supported to keep in touch with family and friends, which had a positive impact on their well-being. People knew how to make complaints and were confident the management team would listen and address their concerns. The service worked closely with community professionals and sensitively explored people’s end of life care wishes.
The management team promoted a caring, person-centred culture where people and staff felt valued. Staff were passionate about their role and consistently placed people at the heart of the service. The registered manager understood their responsibilities to inform people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent reoccurrences. The governance structure of the service ensured there were robust measures to monitor quality, safety and the experience of people within the service. Quality assurance was embedded within the culture and running of the service, to drive continuous improvement. The registered manager had developed effective partnerships to ensure people experienced the best possible outcomes.
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 (report published 28 February 2018)
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.