Standon Gardens Domiciliary Services

Updated 3 November 2022

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 one inspector.

Service and service type

This service was registered as a domiciliary care agency. This is providing personal care to people living in their own houses and flats. However, they were currently not delivering care out in the community. The service was providing 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. We have asked them to add the extra care service type to their records.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post. The registered manager was open and honest they were not often at the service. They explained their desire to plan for the future and the role would pass on to someone else, however other managers, the operations manager and the care manager, were also in place to manage the service.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and we wanted to be sure there would be a manager available to speak with us.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We asked the local authority and Healthwatch for their feedback about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also reviewed information we had received about the service. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with four members of care staff. We spoke with the registered manager, operations manager and care managers.

We reviewed a range of records. This included three people’s care records and medicines records for those who had it included in their care. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed. We also had a follow up video call with the registered manager, operations manager and care manager following the site visit to ask follow-up questions.

Updated 3 November 2022

About the service

Standon Gardens Domiciliary Services is a domiciliary and extra care service providing personal care. All support was currently being provided on one single site with multiple apartments. At the time of our inspection there were seven people using the service.

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

Medicines were not always managed safely, however the care manager took action to address omissions following our feedback. There were enough safely recruited staff to support people, although staff employment histories needed recording more robustly.

Effective systems and processes were not fully in place or embedded to ensure the safety of care was monitored and improvements made, such as in relation to not always identifying medicines management omissions. Fully accurate contemporaneous notes about people’s care were not always recorded. Times of calls and the specific details of each call were not always recorded. The management team had acted on feedback following a monitoring call with the CQC. Improvements to people’s care plans and risk assessments were required as there was missing information about people’s needs and health conditions; this was in progress and one which had been completed was of a good quality.

People felt safe and well supported and staff knew people well. Lessons had been learned when things had gone wrong. Staff understood their safeguarding responsibilities. People were protected from the risk of cross infection.

There was mixed feedback about the quality of food people received, but people received enough food and drink to remain healthy. People felt well supported in line with their needs. 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. Evidence was needed to ensure the legal authority for relatives to make decisions on people’s behalf was verified. Staff received training and support to be effective in their role. People generally accessed other health professionals themselves, or with the support of relatives.

People were treated well, with kindness and compassion. Staff listened to people and people were supported to make their own decisions about their care. People were treated with dignity and respect, by staff who knew them well. People were supported to be independent.

People received personalised care and contributed to the development of their care plans. People were supported to access information in a way that suited them. People were supported to reduce their social isolation and to build positive relationship with staff. People and relatives felt able to complain and these were dealt with. People could choose to discuss their end of life wishes, if they chose to.

People, relatives and staff felt positively about the management team. The registered manager was aware of their duty of candour. People were engaged in the service and asked for their input about their care.

Rating at last inspection

The last rating for the service at the previous premises was good (published 9 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to quality assurance and how the service is monitored to ensure it is safe.

Please see the action we have told the provider to take at the end of this report.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.