Affinity Trust - Domicilary Care Agency - Leeds

The care service has been developed and designed 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 learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using the service: People were supported safely and protected from harm. There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to people.

The management of medicines was safe. Risk assessments had been completed and provided detailed guidance for staff to follow. Incidents and accidents were managed effectively; lessons learnt were shared with staff to reduce the risk of further occurrences.

There were enough skilled and experienced staff to meet the needs of people who used the service. Recruitment checks were completed on new staff to ensure they were suitable to support people who used the service. A comprehensive induction and training programme was completed by all staff.

People told us they felt well cared for by staff who treated them with respect and dignity. People told us they were involved in their care, and what they did on a day to day basis. People's right to privacy was maintained by the actions and care given by staff members.

Initial assessments were carried out to ensure people’s needs could be met. Staff understood people’s likes, dislikes and preferences and people told us they were offered choices about their care.

Some people using the service required end of life care. Care plans recorded people’s preferences for their end of life care.

Where required, people were supported to have sufficient food and drink and their health needs were regularly monitored. Staff followed the advice health care professionals gave them.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive was possible; the policies and systems in the service supported this practice.

A complaints system was in place and there was information so people knew who to speak with if they had concerns.

The provider had embedded quality assurance systems to monitor the quality and safety of the care provided. People were asked for their views and their suggestions were used to improve the service.

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

Rating at last inspection: Good (October 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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

The service is registered to provide personal care to people living in their own homes and to people who required support to access the community. At the time of our visit the service provided personal care to 27 people with learning disabilities and/or autistic spectrum disorder across the city of Leeds.

The service had an operations manager in post who had applied to become the 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.

Systems were in place for the safe management of medicines so people received their medicines safely. Some improvement was needed around the consistent use of ‘as and when ‘required protocols and those for creams and lotions.

The medication audit was not fully effective as it had not identified medication errors we found. However, the registered provider had already identified this and taken appropriate action.

There were systems in place to monitor and improve the quality of the service provided. Staff told us the service had an open, inclusive and positive culture.

Assessments were undertaken to identify people’s support needs. Support plans reviewed contained information about the person's likes, dislikes and personal choices and preferences.

There were risk assessments in place for people who used the service. The risk assessments and support plans had been reviewed and updated on a regular basis. Risk assessments covered areas such as mobility, medicines and independent access to the community. This meant staff had the written guidance they needed to help people to remain safe.

There were enough staff employed to provide support and ensure people’s needs were met. The rota system was flexible to ensure people could access activities of their choice at different times of the day.

Staff told us the managers were supportive. Staff received regular supervision sessions and an annual appraisal. The majority of staff were up to date with training and the registered provider had a system to monitor compliance in this area. Staff told us they had received training which had provided them with relevant knowledge and skills to provide care and support.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Effective recruitment and selection procedures were in place and we saw appropriate checks had been undertaken before staff began work.

The operations manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. MCA is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.

People and their families told us staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people. People told us they were supported to access a wide range of activities which helped them to build and maintain relationships.

People were provided with their choice of food and drinks which helped to ensure their nutritional needs were met. Staff at the service worked with other healthcare professionals to support people’s health and wellbeing.

The registered provider had a system in place for responding to people’s concerns and complaints. The procedure was available in an accessible format to support people to understand better. People told us they knew how to complain and felt confident staff would respond and take appropriate action.

Other people smiled and said 'OK' when asked if they were treated well and got on with the staff who supported them.

We also spoke on the telephone with people who received the service in their own home. They spoke very highly of the service received. Their comments included:

'They are very good, I would have cancelled them if they weren't.'

'Very kind, nice and respect my home and privacy.'

'I am quite happy, have a great team, they turn up on time and we all get on so well.'

People who used the service spoke highly of the staff. People told us they felt safe and were pleased with staff's professionalism. Their comments included:

'They are well trained and very professional.'

'I trust them 100%.'

There were quality monitoring systems in place, which included people giving feedback on their care and support.

One person said; 'The staff are fantastic, I am very happy with the support I get.'

Another person said;' I am very happy with the care I get.'

We observed staff being friendly and warm towards people. We observed that staff and service users had positive relationships and that people appeared relaxed and comfortable with their surroundings, with staff and the activities they were engaged in. We saw that staff supported people to make choices about their daily living.

We spoke with four members of staff who told us that the agency was very supportive, particularly with emergency out of office support, and provided good opportunities for training.