Centre 404 Domiciliary Care

Centre 404 provides support to people living in their own homes and in supported living settings. The supported living houses are designed to support different numbers of people depending on the size of each house and other people are supported in their own family home or in their individual accommodation. The provider also supports people with learning disabilities and autistic spectrum conditions.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of the key questions of Safe the service was able to demonstrate how they were meeting some of the underpinning principles of right culture. The service addressed potential risks to people being kept safe from potential avoidable harm by those caring for them.

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 16 February 2018).

Why we inspected

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We undertook this targeted inspection as a response to an specific concern that had been raised about verification of background checks for temporary agency care staff. The provider has a children’s service registered with Ofsted (The national regulator for children’s day and residential care services) who had found one agency worker had not had valid disclosure and barring service check (DBS). We undertook this targeted inspection to check if the adult service registered with Care Quality Commission (CQC) was maintaining safe employment practices for staff, most specifically for temporary staff working with people.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

We also looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has not changed following this targeted inspection and remains Good.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Centre 404 on our website at www.cqc.org.uk.

Follow-up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection was short notice, which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 4 and 18 August 2015 the provider met all of the legal requirements we looked at and was rated Good.

At this inspection we found the service remained Good.

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 and associated Regulations about how the service is run.

Staff respected people’s privacy and dignity and worked in ways that demonstrated there was diligence at ensuring this. People’s preferences were known about and were recorded and staff worked well to ensure these preferences were respected. The provider and staff teams worked hard to ensure that the service offered an outstandingly caring environment. The service was bespoke and built around the people that used it and was not operated for anyone’s convenience other than the people that used the service. Compassion and respect were at the heart of the values that staff displayed and people’s abilities, or impairment to their abilities, did not dictate how they were supported to live their lives.

People using the service, relatives and other stakeholders were highly satisfied with the way the service worked with people and the steps that were taken to keep people safe from potential avoidable harm.

The service was diligent with ensuring that the requirements of the Mental Capacity Act (2005) were complied with. Where Deprivation of Liberty issues were applicable, this too was managed well and proper consultation took place to help protect people’s human rights.

People who used the service had a variety of support needs, in some cases highly complex needs, and support plans clearly described people’s care and support needs and provided clear guidance for staff about how to meet these needs. Any risks associated with people’s care were assessed, and the action needed to minimise risks was recorded. Risk assessments were updated regularly and did not place restrictive limitations on the reasonable risks that people were allowed to take.

Staff training described mandatory training required for all staff as well as specific training required where staff worked with people that had specific care needs that required staff to undergo specialised training. Staff participated in regular supervision which was designed as a supportive process for staff as well as to address their development and work with the service. Staff appraisals took place yearly and development and training objectives were set arising from the appraisal system.

People were informed about how to complain and were supported to raise concerns if they were unable to do it independently by using advocacy services if a family member or friend could not assist with this on their behalf. If concerns were raised these were listened to and the provider was open about action taken and changes made as a result.

People who used the service, relatives and stakeholders had a range of opportunities to provide their views about the quality of the service. The provider worked hard to ensure that people were included in decisions about their care and their views about how the service was run were respected and taken seriously.

At this inspection we found that the service met all of the key lines of enquiry that we looked at and was not in breach of any of the regulations.

Further information is in the detailed findings below.

We looked at three personal care records during our visit. These were person centred and reviewed regularly. We saw evidence that other professionals had contributed to these.

We met three people who used the service and spoke with a family carer. We were told, "The staff are brilliant," and, "I feel it is a very positive partnership."

We saw that medicines were stored, managed, recorded and administered appropriately. Staff had received training in the safe handling and administration of medicines.

We saw that effective recruitment processes were in place, and that checks had been undertaken regarding the suitability of staff prior to commencement of employment.

We saw that there was an effective complaints system in place. People were supported to make complaints and knew what to do if they had a concern.

'I love it here', 'I like my carer', 'It's good here', 'I feel safe here' and 'I can talk to people'.

People told us that when they were supported with personal care this was done in a way that respected their personal preferences and promoted their privacy and dignity. We looked at the personal files of several people using the service. We found that each person had an individual care plan that addressed a range of health, social and personal care needs.

We found that people experienced care and support that met their needs. We also found that people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff we spoke with told us that they received appropriate training and supervision for the role they were undertaking. We saw training records that evidenced that staff received regular training

The provider had an effective system to regularly assess and monitor the quality of service that people receive.