Archived: Hampshire - Domiciliary Service

Hampshire Domiciliary Service offers domiciliary care to people in their own homes and across six ‘supported living’ settings. People who use the service have learning disabilities, autism spectrum disorders and/or physical disabilities. 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 such as activities, community access and domestic support. At the time of the inspection 19 people required support with personal care tasks across the six ‘supported living’ settings. Each of the ‘supported living’ settings offered different types of accommodation options which included self-contained flats within one building, a single person service and houses of multiple occupancy. No one accessing the provider’s domiciliary care service, which is registered under the same location required support with personal care at the time of the inspection. The provider Autism Hampshire is a registered charity and a not for profit organisation.

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

There were systems and processes in place to review the quality of the services provided to people, however these were not always effective to ensure the provider maintained oversight. For example, findings from this inspection highlighted where improvements were required in relation to the governance and record keeping of communication with the local authority, records relating to actions taken to respond to informal concerns raised by people and their relatives and the governance of staff supervision. We noted there was a clear management structure in place and staff consistently told us they felt supported and could access advice and guidance from the senior management.

We found in day to day practice 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. Where people required additional support to make decisions, practices supported people in line with the principles of the Mental Capacity Act 2005. Staff spoke positively about the range of training opportunities available to support them to continually develop their skills.

People’s care plans were person-centred and focused on their strengths and abilities. Where people required support to manage feelings of anxiety and associated behaviours, staff support was readily available, and responses were proactive. People received appropriate levels of care and support that was responsive to their needs. People were provided with a range of opportunities to engage in social activities and staff encouraged people to build meaningful relationships through extended social networks.

People were protected from the risk of experiencing abuse. Risks to people had been assessed and measures were put in place to ensure their safe management. There were clear safeguarding processes in place to identify, record and respond to all incidents and accidents. People were supported to receive their medicines safely and as prescribed. We received mixed feedback from relatives around movement of staff across the different setting’s, however the provider had an on-going recruitment drive and had taken steps to promote consistency following an organisational restructure. People had access to appropriate levels of support to meet their needs.

People were supported in a kind and caring manner. We observed people had developed positive and trusting relationships with staff which promoted them to achieve positive outcomes. Staff practices promoted an inclusive, non-judgemental culture and people were empowered to embrace their diversity. Staff treated people with dignity and respect and were passionate in promoting person centred care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was previously rated as good at the last comprehensive inspection. That report was published on 08 February 2017.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Hampshire Domiciliary Service offers a supported living service to people within their own homes or shared houses. People who use the service have learning disabilities, autism spectrum disorders and/or physical disabilities. People who use the service are supported with personal care, medicines, cooking, shopping, activities and other day to day tasks. At the time of this inspection 21 people were using the service.

The service had 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.

People and relatives said the service was safe and they felt comfortable raising any safety concerns with staff. One person who used the service told us, “I like it here.”

Staff had completed training in how to protect people from harm and abuse and understood the different forms and potential signs of abuse. Staff told us they had confidence in the management team to deal with safeguarding issues promptly and effectively. Records showed safeguarding concerns were recorded and dealt with appropriately and promptly.

A thorough recruitment and selection process was in place which ensured staff had the right skills and experience to support people who used the service. Identity and background checks had been completed which included references from previous employers and a Disclosure and Barring Service (DBS) check.

Contingency arrangements were in place in case of accidents or staff emergencies and on-call management arrangements were in place. Each person had a personal emergency evacuation plan (PEEP) which meant people could be evacuated safely in the event of a fire.

The arrangements for managing people’s medicines were safe. Medicines were stored securely and there were clear policies in place for supporting people with their medicines.

Risks to people’s health and safety were assessed and managed, without compromising people’s independence.

Staff training in key areas was up to date. Staff told us they felt confident to care for the people who used the service.

Staff understood the Mental Capacity Act 2005 and how to apply this to people in their care. Staff understood the need to support people to make their own decisions and the role of best-interests decision-making.

People were supported to maintain a balanced diet and to have enough to eat and drink. People were supported to maintain their physical and mental health needs.

Relatives we spoke with said staff were caring. Comments included, “Staff care about their residents,” “Staff have a great relationship with clients, they talk regularly and are amenable” and “Staff are brilliant.”

Staff supported people to do the things they enjoyed and also encouraged independence with daily living. Relatives told us how staff had gone ‘over and above’ what was expected of them.

Support plans contained clear information about the person's level of independence as well as details of areas where staff support was required. Support plans detailed people's needs and preferences and risk assessments were in place where appropriate.

Relatives told us the service was well-led and described the registered manager and the management team as approachable. Relatives and staff told us there had been changes within the organisation due to a re-structuring exercise and things were more settled now.

There were systems in place to gather regular feedback from people who used the service and their relatives. Feedback was acted upon.

The provider ensured the quality of the service was assessed and monitored by carrying out regular audits of all aspects of the care provided.