Background to this inspection
Updated
20 September 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in 16 ‘supported living’ settings covered by six service managers, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 24 hours' notice of the inspection visit because we wanted to be sure the registered manager was available to speak with us.
Inspection activity started on 6 August 2019 and ended on 14 August 2019. We visited the office location on 6 August 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We visited the office where the service was run from and we visited one supported living location. We spoke with three people who used the service. We spoke with six relatives about their experience of the care provided and a further relative provided us with emailed feedback. We spoke with six members of staff including the registered manager, service managers and care workers. A further five care workers provided us with a response to our questions via email.
We reviewed a range of records. This included five people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found which was received.
Updated
20 September 2019
About the service
Mencap North Hampshire Domiciliary Care Agency is a domiciliary care agency providing care and support to people in supported living houses across the north of Hampshire. The service predominantly provides support to people with a learning disability.
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.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Where they do we also consider any wider social care provided.
At the time of this inspection the agency was providing a personal care service to 38 people.
People’s experience of using this service and what we found
People and their relatives thought the service provided safe care. Staff were aware of risks associated with people’s needs and these were assessed with plans developed to mitigate these. People received their medicines as prescribed although some improvements were needed with medicine records. Staff knew how to safeguard people from abuse. There was enough staff to meet people’s needs. However, agency staff were used to cover vacant hours which caused concern with some relatives and staff. A recruitment drive was in place to address this. Staff were recruited safely.
People’s needs were holistically assessed prior to the person using the service. People were asked about their protected characteristics to inform people’s care and support non-discriminatory practice. Staff were supported through supervision and training.
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. People were supported to access a range of healthcare professionals and other professionals to meet their needs and people’s nutritional and hydration needs were met.
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. People were supported by staff who were kind, caring and compassionate.
Improvements were needed to ensure people and their relatives had their concerns and complaints resolved and we have made a recommendation about this. Staff were knowledgeable about people needs, care was person-centred and individualised. People enjoyed a range of activities that met their needs.
An effective system was in place to monitor the quality and safety of the service. People received person-centred care and staff put Mencap’s values into practice on a day to day basis. Relatives and staff had mixed views about the management of the service. The service worked in partnership with other agencies to promote and support people’s wellbeing.
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 23 February 2017.)
Why we inspected
This was a planned inspection based on the previous rating.
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.