Background to this inspection
Updated
19 May 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 2 inspectors.
Service and service type
This service is a domiciliary care agency. This service provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 12 April 2023 and ended on 20 April 2023. We visited the location’s office on 12 April 2023 and 17 April 2023.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people and 2 relatives about the experience of care provided. We spoke with 5 members of staff, including the registered manager and 4 care staff. We reviewed a number of care plans and also looked at people's medication administration records. We reviewed a selection of documentation about the management and running of the service. We looked at recruitment information for 3 members of staff. After the inspection We received further evidenced from the registered manager via email to verify information they told us during the inspection.
Updated
19 May 2023
About the service
Wolds & Coast Domiciliary Care Agency is a domiciliary care service providing personal care for people who are living with dementia, mental health conditions, physical disability, sensory impairment, older people, younger adults and people with a learning disability and/or autism in their own home. At the time of our inspection 11 people received support from the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
Risks to people continued to not be effectively managed. Health conditions continued to not be sufficiently risked assessed.
Medicines continued to not be managed safely. This included the management of homely remedies and some people were not receiving their medicines as prescribed.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. At time’s people’s choice was restricted due to staffing levels. Capacity assessments had not always been recorded.
Right Care
There was not always sufficient staff on duty. People did not always receive person centred care due to the staffing levels.
Staff had not always had training in supporting people with a learning disability to ensure they were supporting people appropriately.
People had good relationships with the staff. People were supported to maintain relationships with their relatives.
Right Culture:
Staff felt supported by the registered manager but did not always feel supported by the provider. Although the registered manager recognised improvements where required, they had not always had the time and resources to make these.
People, their relatives and staff were supported to give their views in meetings and a satisfaction survey was in the process of been carried out to gather people’s feedback.
The provider's quality monitoring processes were not robust and had not always identified concerns and improvements in the service identified during the inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 December 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
At our last inspection we recommended that the provider seek advice from a reputable source regarding auditing and action planning. At this inspection we found the provider had failed to make the required improvement and the provider was now in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wolds & Coast Domiciliary Care Agency on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to risk management, medicines, staffing and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
We have made recommendation regarding person centred care.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.