Archived: Domiciliary Care Service

Updated 8 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 25 and 31 October 2017 and was conducted by one inspector. It was a comprehensive, announced inspection.

We reviewed information received about the service, for example the statutory notifications the provider had sent us. A statutory notification is information about important events, which the provider is required to send to us by law. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We found the PIR reflected the service. We also contacted the local authority commissioners to find out their views of the service provided. These are people who contract care and support services paid for by the local authority. They had no significant concerns about the service.

Before the inspection visit we sent surveys to people who used the service to obtain their views about the quality of care they received. Surveys were returned from nine people who used the service and one relative. During the inspection visit we spoke with five people who used the service. We spoke with the provider, the senior administrator, the registered manager, the registered manager of services [known throughout the remainder of the report as ‘the manager’], the deputy manager, three team leaders, a senior support worker and a support worker. Following our inspection visit we spoke with two health care professionals. Health care professionals are people who have expertise in particular areas of health, such as nurses or consultant doctors.

Many of the people who used the service were happy to talk with us about their daily lives, but they were not able to tell us in detail about their care plans because of their complex needs. However, we observed how care and support were delivered in communal areas and reviewed five people’s care plans and daily records to see how their care and treatment was planned and delivered. We looked at other records related to people’s care and how the service operated, including medicine records, the provider’s quality assurance audits and records of complaints.

Updated 8 December 2017

The inspection took place on 25 and 31 October 2017. The inspection was announced. This was to ensure the manager and staff were available to talk with us about the service when we visited. At the last inspection, the service was rated Good overall. At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Domiciliary Care Service provides personal care and support to people with learning difficulties, in their own homes. The provider owned two properties where people had private tenancies with the provider. One property was a shared ground floor flat and the other was a purpose built property which consisted of self-contained flats with some communal rooms. The provider leased two other properties, where people had private tenancies with the provider. These properties consisted of self-contained flats with some communal rooms. There was a staff room in these buildings, where staff stayed to provide overnight support. Some other people received support in their own homes in the community. At the time of our visit, 49 people received personal care from the service.

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. A recent change to staffing structure meant the registered manager was preparing to leave the service and a newly appointed manager was in the process of taking over their role and would apply for registration with the CQC in the future.

The providers’ values were person-centred and made sure people were at the heart of the service. Staff shared this view and had a common vision to provide an environment where people were enabled to live their lives as they chose, pursue their interests and maintain their independence. Staff demonstrated they cared through their attitude and engagement with people. People were valued and staff understood the need to respect their individual wishes and values.

People were encouraged to plan ahead, set personal goals and maintain their interests. They were supported to take part in social activities which were meaningful to them and these improved the quality of people’s lives.

The provider was innovative and demonstrated sustained improvement to the quality of care they delivered. They worked in partnership with other organisations to make sure they followed current best practice and provided a high quality service.

The managers were dedicated to providing quality care to people. They valued staff and promoted their development. There was an open culture at the service where staff felt well supported, able to raise any concerns and put forward suggestions for improvements. The provider encouraged people to provide feedback on how things were managed and to share their experiences of the service in creative ways which suited their needs.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks, while promoting people’s independence. People and their families were included in planning how they were cared for and supported. The provider regularly checked that the premises and equipment were safe for people to use.

Staff understood their responsibilities to protect people from the risk of abuse. The provider checked staff’s suitability for their role before they started working at the service and made sure there were enough staff to support people safely. Medicines were administered and managed safely.

People were cared for and supported by staff who had the skills and training to meet their needs. The managers and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to maintain a healthy diet that met their preferences and were referred to healthcare services when their health needs changed.