Archived: Domiciliary Care Service

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.

People told us that their care and support was planned to meet their individual needs. Relatives said, 'The plan is what X wants' and 'The care plan was tailored to Y's needs.' People's care plans were regularly reviewed and updated to reflect their increasing independence.

The manager followed the provider's medicines policy. They made sure that only appropriately trained staff supported people to take their medicines.

The three staff we spoke with told us they felt supported by the management. They said they had regular opportunities to discuss any concerns and their training and personal development. Staff said, 'The team leaders are very supportive' and '. We discuss ideas and make suggestions.'

The manager's quality assurance checks included asking people their opinions on the quality of the service. The manager told us that this year they planned to ask people's relatives to support them to complete the survey, instead of their keyworkers, to make sure that people responded independently.

We gathered evidence of people's experiences through speaking with two people who use the service. We spoke with a member of staff who supported the two people we spoke with about their experiences.

People we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and that reviews were held to reassess their needs. We saw that people and family members had provided information on their care plan.

We saw that the care plans were person centred and reflected people's needs. This meant that the care plan was based on the needs of the person. We saw that people's needs were reassessed and where necessary the care plan was updated. We saw that people's like and dislikes were clear within their care plans.

People we spoke with told us that staff were friendly and supportive. We saw their were regular members of care staff who provided people's personal care. Continuity of staff should mean that people receive their care consistently as staff have an increased understanding of people's needs.

We spoke with staff about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding abuse.

We saw records were kept up to date and stored securely.