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Royal Mencap Society - Lincolnshire Domiciliary Care Agency Outstanding


Inspection carried out on 16 April 2019

During a routine inspection

About the service: This service is a domiciliary care agency. It provides personal care to 50 people living in their own houses and flats. It also provides other support to people living with a learning disability. As the Care Quality Commission (CQC) does not regulate domestic support, this inspection relates only to people receiving the regulated activity of personal care.

The service had been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.

People’s experience of using this service: The service was exceptional in placing people at the heart of the service and its values. It had a strong person centred and local community-based ethos. Staff and the service's management told us how they were passionate about providing outstanding person-centred care to people when they needed it.

People's needs, and wishes were met by staff who knew them well. We saw and were told of many examples of staff going 'above and beyond' to help and support people they cared for.

There was a system in place to carry out quality checks. These had been carried out on a regular basis. People were asked their views in person and via questionnaires.

Medicines were managed safely. Arrangements were in place to monitor and manage medicines.

We saw evidence of caring relationships in place, and a clear commitment to support people at difficult times with compassion, respect and affection. People said they felt safe. There was enough staff to support people and staff were flexible in their approach. Efforts were made to ensure people had the same care staff visiting.

People were supported to have nutritious meals according to their likes and dislikes and their dietary needs had been catered for. This information was detailed in people’s care plans. Staff followed guidance provided to manage people's nutrition.

Care plans contained information about people and their care needs.

Staff had received training to support their role. Staff had received regular supervision and appraisal.

People had good health care support from professionals. The provider and staff worked in partnership with health and care professionals.

Staff were aware of people's life history and preferences and they used this information to develop positive relationships and deliver person centred care. People felt well cared for by staff who treated them with respect and dignity.

People were supported to access a range of leisure pursuits and participate in the community they lived in.

Although the provider was not responsible for the environments which people lived in they had put in place arrangements to work with the housing providers to ensure they met people’s needs.

Arrangements were in place to manage and prevent cross infection and ensure good infection control systems were in place.

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.

The provided had displayed the latest rating on the website. When required notifications had been completed to inform us of events and incidents.

More information is in the detailed findings below.

Rating at last inspection: Good (Report Published January 2016).

Why we inspected: This inspection was carried out based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect sooner.

Please see the ‘action we have asked the provider to take’ section at the end of this report.

Inspection carried out on 11 January 2016

During a routine inspection

Royal Mencap Society – Lincolnshire Domiciliary Care Agency provides personal care and support for people in their own homes who have a learning disability or autistic spectrum disorder. The service can provide care for adults of all ages. At the time of our inspection the service was providing support for 60 people most of whom were younger adults. About one half of these people lived in properties that they shared with other people who also received assistance from the service. In this report we refer to the shared properties as being, ‘shared homes’. Most of the remaining people lived in properties for which they were the sole tenants. We refer to these sole tenancies as being, ‘private homes’. The service covered north Lincolnshire including Boston, Skegness, Market Rasen, Lincoln and Gainsborough.

There was 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People had been supported to promote their wellbeing, to reduce the risk of accidents and to safely manage medicines. There were enough staff to support people who lived in the shared homes and to visit people in their private homes. Background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to support people in the right way. This included being able to assist people to eat and drink enough in order to stay well. In addition, people had been supported to receive all of the healthcare assistance they needed.

The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had received all of the support they needed including people who had special communication needs or who could become distressed. People had been consulted about the support they wanted to receive and they had been given all of the assistance they needed. Staff had supported people to express their individuality including pursuing their interests and hobbies. There was a system for resolving complaints.

Regular quality checks had been completed to ensure that people received all of the support they needed and people had been consulted about the development of the service. Staff were supported to speak out if they had any concerns because the service was run in an open and relaxed way. People had benefited from staff receiving and acting upon good practice guidance.

Inspection carried out on 11 February 2014

During a routine inspection

There were systems in place to make sure that any person who used the service had their right to make decisions about their support and care valued and respected. People who used the service and family members of other people, who used the service, were actively consulted in decision making processes.

People who used the service and family members of other people who used the service had positive comments to make about the standard and quality of the support and care provided. Support and care provided maintained and promoted people’s health and wellbeing.

Systems were in place to safely and appropriately support people with equipment that they needed to maintain their independence, health, safety and comfort needs.

There were sufficient numbers of trained and skilled members of staff to provide people who used the service with safe and appropriate support and care to meet their individual needs.

There were systems in place which provided any person who used the service, or their representative, with opportunities to share their views and suggestions with the agency. Other quality assurance systems were in place to protect people from unsafe and inappropriate support and care.

Inspection carried out on 7 December 2012

During a routine inspection

We did not speak with people who use the service. We visited the Bourne Mencap office. The Bourne office coordinates the personal care service for locations in Boston, Spalding and Bourne.

We saw people had been involved in appointing support staff to work in their home. We read comments people made about a prospective candidate. One person said, “Good to talk to. Would like him to work here.” Another person said, “Liked him a lot.”

People had risk assessments specific to their individual need. People were supported to maintain their independence and learn new skills.

The staff we spoke with told us how to identify signs of abuse. Staff told us how they would report safeguarding concerns within their organisation.

Staff told us each house held separate tenants meetings. People who lived in the house discussed matters which were important to them. One member of staff told us, “One group wanted permission to decorate their house. We supported them to contact the landlady and they gave them permission.”