Hertfordshire Domiciliary Care Agency

Royal Mencap Society - Unit 7 Sundon Business Park (Luton DC) is a domiciliary care service. It provides care and support to people with learning disabilities or autistic spectrum conditions, living in 16 supported living settings spread across Bedfordshire, Buckinghamshire and Hertfordshire. At the time of the inspection, 44 people were being supported with personal care.

People’s experience of using this service:

People’s support focused on them having as many opportunities as possible to gain new skills and become more independent. This supported the principles of ‘Registering the Right Support’ and other best practice guidance. These ensured 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. People were particularly proud that they had been supported to register to vote and they were looking forward to exercising this right in future elections.

People were protected from harm by staff who were confident in recognising and reporting concerns. People were safe because potential risks to their health and wellbeing had been managed well. There were enough staff to support people safely and to enable them to take part in a range of activities they enjoyed. People were supported well to take their medicines. Lessons were learnt from incidents to prevent recurrence. Staff followed effective processes to prevent the spread of infections.

Staff had the right skills to meet people's needs effectively. Staff were well supported and had information to meet people’s assessed needs. People had enough to eat and drink and were supported to make healthy food choices. People had access to healthcare services when required. This helped people to maintain their health and well-being.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were fully involved in making decisions about their care and support. People were involved in planning and reviewing care plans. Staff supported people in a way that respected and promoted their privacy and dignity. They encouraged people to be as independent as possible.

People were happy with how staff supported them to meet their individual needs. They said this had been done in a kind and person-centred way. Complaints were managed well and there was learning from these to reduce the risk of recurrence. The service did not currently provide end of life care, but they had including some information in people’s care plans. They would do more to further improve on the quality of this information.

Audits and quality monitoring checks were carried out regularly to continually improve the service. The provider had systems to enable people, relatives and staff to provide feedback about the service. People's experiences of the service were positive. Staff felt fully involved in ensuring the service met its regulatory requirements.

Rating at last inspection:

At the last inspection, the service was rated Good (report was published in October 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.

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

Royal Mencap Society - Unit 7 Sundon Business Park (Luton DC) is a domiciliary care service which provides personal care and support to people living in their own homes, within shared supported living premises. The majority of people have learning disabilities and/or autistic spectrum disorders.

There was a registered manager in post. 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 were safeguarded from avoidable risk of harm and staff understood the process to follow to report concerns regarding people’s safety. There were risk assessments in place which detailed how people could be supported safely. Protocols and guidelines were in place to support staff to develop consistent approaches to the management of behaviour which might have impacted negatively upon others. People’s care plans were person-centred and based on established and stated outcomes for people. These were subject to regular review with involvement from people and their relatives where possible.

People’s healthcare needs were identified and met by the service, and good links had been formed with external healthcare agencies. If people required support with eating and drinking then their likes/dislikes and dietary needs were listed in their care plans. People were supported to explore their hobbies, interests and activities, and work towards objectives which promoted learning and independence. They were treated with dignity and respect and had opportunities to have their opinions and views heard. People gave their consent to receiving care and support at the service.

Staff received a variety of training to enable them to carry out their duties effectively and completed a thorough induction programme when they first joined the service. Staff understood the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DoLS) and these were applied correctly in practice. The recruitment processes used to employ new staff were safe and ensured that staff employed had the skills, character and experience to meet people’s needs. There were enough staff to keep people safe and protocols in place in case of severe shortages or staffing issues. Team meetings were held both centrally for the management team and within people’s individual houses.

Staff were not always supported through a program of supervision and appraisal and the frequency of these varied between the different supported living premises.

There was a robust quality monitoring system in place for identifying improvements that needed to be made across the service. People, staff and relatives were positive about the management at all levels and felt supported to develop and contribute to the service.

We noted from the four care files we looked at, that people were offered support at a level which encouraged independence and ensured their individual needs were met. People told us they felt safe and all the staff were all kind and helpful. One person told us, "I like everyone, they look after me well here".

We could see from records that people were encouraged to be involved in planning and making decisions about their care and support. People also told us they met with their 'key worker' each month and they could discuss anything they wanted to. The were confident that if they had any problems the staff would listen to them, and help them resolve any issues they had.

The provider had systems in place to ensure people were involved in the quality monitoring processes for this service. People were encouraged to share their views and opinions to help improve the standard of care provision.