We carried out a review of the data available to us about Park View Domiciliary Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Park View Domiciliary Care, you can give feedback on this service.
Park View Domiciliary Care agency is registered as a domiciliary care agency, but it was clear at inspection that people needing personal care support were living in three shared tenancies as part of a supported living set up, where staff were available on site if needed 24 hours a day.
People with learning disabilities were supported to live in their own tenancies across three shared houses. The office for the service is based in one of the shared houses is open during office hours and an on-call system is available to staff based in the houses out of hours. Sleep-in rooms are provided in each house for staff to ensure support is provided 24 hours per day.
At the time of our inspection the service was providing personal care to eight people across the three shared houses in Deal. 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.
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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
People's experience of using this service and what we found
Staff said they were well supported. Improvement was needed however to maintenance of records of staff supervision and appraisal; to demonstrate that staff training development and performance needs were being addressed.
The provider was a visible presence in the service and had good oversight of the service, but had not developed a system of quality monitoring to provide assurance that all aspects of the service were working well, and people were safe. This is an area for improvement.
People felt safe and were treated well by staff who showed compassion and kindness.
One person was able to tell us that they felt safe and secure in the knowledge that staff were onsite 24 hours each day. Most people were not able to give good feedback about their experiences due to communication issues, but we observed them to be relaxed and comfortable in the company of staff and actively sought their attention. We spoke with a relative and care manager who commented positively about the service.
People were protected from the risk of harm because staff had received appropriate training knew how to report and act on concerns, accidents and incidents to keep people safe.
There were enough staff to support people. Staff continuity was good and meant people were able to build relationships with staff that knew them well and how they preferred to be supported. There was a safe system of recruitment in place to ensure suitable staff were employed. Staff always said they felt supported. The provider was visible in the service daily and staff found them approachable and available to discuss issues and keep them informed.
People’s health care needs were supported to maintain their health and wellbeing.
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. Policies and procedures were in place to support and guide staff practice.
No formal complaints had been received and people were encouraged to raise any concerns.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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.
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 25 January 2017)
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make some improvements. Please see the Well Led section of this full report. We found no evidence during this inspection that people were at risk of harm from this.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
Park View Domiciliary Care agency provides care and support services to people with a learning disability living in their own homes. The service is based in an office in of one of the buidlings that houses people’s flats. The office is open during office hours and an on call system is in place outside of these times. The service currently provides personal care to seven people in Deal, who share different houses and some people live in a flat.
The service has a registered manager. 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.
The service had a person centred culture where people were supported to have the lifestyle they chose. Individual meetings were held with people to plan their care and discuss their goals and aspirations, so that the service gave support to people in the way they wanted.
Each person had a support plan that they had been involved in writing and updating. Pictures and photographs were included to make the plans meaningful to people. Staff had a good understanding of how people preferred to communicate and adjusted their support to meet peoples’ individual needs. Staff knew people very well and people told us they were comfortable in telling staff about any concerns or complaints they might have. People said that the staff would listen to them and act on their concerns.
People were supported to be as independent as possible and try new activities to develop their skills. Risk assessments were completed to make sure people were protected from unnecessary accidents. People were given the right support to take their medicines safely.
Active healthy lifestyles were encouraged and people were supported to prepare their meals and eat healthily. People were helped to manage any health conditions as well as they could. Health and social care professionals were involved and people were supported to attend healthcare appointments.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. The service was supporting people to make decisions about their health and wellbeing. Staff respected when people made unwise decisions but made sure people had all the information they needed and involved other professionals.
People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. In supported living services applications to deprive a person of their liberty must be made to the Court of Protection. The service was working within the principles of the MCA. The provider took advice and at this time no applications to deprive people of their liberty needed to be made.
People said they were well supported by the staff and registered manager. One person said they felt much better now than before they the service, commenting, “I get good food and my tablets every day and I feel safer here too.”
Everyone using the service was supported with the lifestyle they chose. Some people liked going out and having an active lifestyle, some people preferred plans and structure and others liked to have a quieter more sedentary lifestyle. People kept in touch with families and friends, helped as needed by staff. There were links with the local and wider community and people had friends locally and knew their neighbours.
A health and social care professional involved with some of the people’s support said, “This service will always go the extra mile for people.”
Staff were trained and competent to carry out their roles. Staff were supervised and had yearly appraisals. All staff were checked before they started work at the service to make sure they were of good character and safe to work with people. There were enough staff to meet people's needs.
Staff knew about abuse and the signs to look for and how to report it. People had experienced difficulties in the past where they had been taken advantage of, for example, with their finances or medicines. The registered manager and staff had helped people resolve these issues and find ways to prevent them from happening again. A health and social care professional commented, “[The registered manager] and staff are passionate about supporting individuals’ rights and strongly advocate for social justice for individuals who belong to groups who are marginalised in society.”
People were fully involved in how the service supported them. The registered manager involved people in the development and shaping of the service and took all feedback from people, families and visiting health and social care professionals into account.
The registered manager was experienced in working with people with learning disabilities and providing person centred care. The CQC had been informed of any important events that occurred at the service, in line with current legislation.
Suitable arrangements were in place to make sure medication was managed and administered safely.
Staff we spoke with had a good knowledge of people's needs and knew how they liked their care provided.
Records were clearly written, in good order and stored securely to maintain people's confidentiality.
People said they talked to staff if they had a problem. People said the staff helped them and listened to them. People were given the support they needed to make decisions about their care and support. We saw that staff gave person centred support that varied depending on each person's level of ability and needs.
Staff received relevant training and said they were confident to support the people using the service. Staff said they enjoyed working at the service and said they were well supported by the manager.
There was an effective informal quality monitoring of the service which included gathering people's views and using these as a basis to determine future developments.