Archived: Autism Sussex Domiciliary Care, West Sussex

Autism Sussex Domiciliary Care, West Sussex forms part of a larger service provided by Autism Sussex. This includes outreach services, children’s services and day centres, all of which fall outside of the Care Quality Commission’s scope of registration. The domiciliary care service provides personal care to people living in their own homes. At the time of this inspection six people were receiving personal care from this service. No one using the service at the time of the inspection received assistance with their medicines. The service works with people with a learning disability and/or autism.

The service had a registered manager in place. 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 were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence.

Relatives told us that people were safe at the service and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.

Relatives told us that people were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way.

Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.

There were enough staff deployed to support people with their assessed needs. The registered manager considered people’s needs when allocating staff and staffing levels were calculated appropriately. The registered manager followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People benefited from receiving a service from staff who worked well together as a team. Staff were confident they could take any concerns to the management and these would be taken seriously. Relatives were aware of how to raise a concern and were confident appropriate action would be taken.

People and their relatives were empowered to contribute to improve the service. They had opportunities to feedback their views about the service and quality of the care they had received.

Below is a summary of what we found. The summary describes what people who use the service and the staff told us, what we observed and the records we looked at. During the time of our inspection there were 5 people who use this Domiciliary Care Service. We spoke with one person, two family members on the telephone, senior support worker and five support workers. We looked at five care files, four staff personal files and a number of relevant records.

We used the information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Is the service safe?

We found support plans were comprehensive with pen picture for each individual. This described each person and their individual routine. The plans were reviewed on a regular basis and were up to date. There were individual risk assessments in place that were reviewed frequently and ensured that people were safe at home where care was delivered.

We spoke with one person and three relatives who received support from the service. The relatives told us that a safe level of service was provided by the agency. They said that staff ensured the safety of the people both when attending to their needs at home, when accompanying them within the community and on planned trips.

We found risk assessments were in place to ensure the safety of people who use the service and staff working with them. There was a system in place for staff to report any incidents and learn from concerns raised to ensure the safety of people who they supported.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report what we find.. While no applications had been submitted, appropriate policies and procedures were in place.

Is the service effective?

We found during our inspection that the service was effective. This was because in the support contract we found clear and sufficient information about what level of care support had been agreed by either party. We found that people and their representative were involved in the process of their assessment. Relatives we spoken with told us that their family member had control over the level of care and support they required. They were able to dictate what was appropriate for their individual needs. We found that people were supported to give valid consent to the level of support that they required.

Is the service caring?

We found that the service was caring. Each person had a personalised support plan that was reviewed on a regular basis. Relatives we spoke with told us about the level of input they had in the care planning and how the support worker was reactive to their change in needs. This ensured the care and support they received were appropriate to their needs.

People we spoke with and their relatives told us the following: 'Thumbs up', 'My son's support worker is very good to him and understands him quite well', 'I am satisfied with the personal care that X receives from them', 'I can always phone X the senior support worker and discuss any concern that I may have', 'They always respond to my question and will help to make things better'. This reflected that people who use the service felt that staff were caring, supportive and met their needs.

We observed staff supporting one person at the agency activity centre and found that staff were courteous, treated them as an individual and with respect. They ensured that they were supported in the making of decisions as well as taking a lead in the daily activity.

Is the service responsive?

We found that the service was responsive. They had a system in place to deal with concerns and complaints. Where people had raised any concern or complaint, we found that the service had responded to them in a timely fashion and taken appropriate action as required. Relatives we spoke with were aware of the complaints procedure in place. They felt that their views were taken into consideration and acted upon accordingly.

Is the service well-led?

During the inspection we found that the service was well led. Relatives we spoke with told us they found the senior support worker and the manager worked well with them and other related agencies to ensure that the people were supported.

We found that the management had notified the Care Quality Commission and the local authority Safeguarding Agency of notifiable incidents that needed reporting in a timely fashion. We were told that these incidents were discussed during team meetings and they would learn from these outcomes to prevent further risk. We saw that the agency had audit tools in place to ensure that the quality of service was maintained to a good standard and was consistently safe.

Staff we spoke with told us that they had very good support from the management, were able to express their views and felt that they were listened to.

People and families spoke positively about the service and the staff who supported them. One person said, "I get on really well with them. They always treat me with respect and ask my opinion".

Family members told us that they had confidence in the agency and staff. They had been involved in their relative's care and support planning as appropriate and felt the staff were meeting the needs of their relative. One person said, "Its been hugely successful". Another person said, "They have a very caring approach".

We spoke with staff about their work and they demonstrated a good knowledge of the needs of the people they supported. We also spoke about the recruitment practices of the agency and staff confirmed that the agency had a robust system in place to protect people. Staff also told us that they had a good induction and opportunities to work alongside colleagues when they started.

We found that the agency had an effective care planning and support system in place. Their recruitment practices were sound and they monitored the quality of the services provided to people to ensure peoples' needs were being met.