Petersham Community Team (DCC Homecare Service)

Petersham Community Team (DCC Homecare Service) provides a domiciliary care service for adults with learning disability in two houses in or near to Long Eaton. We call this type of service 'supported living'. At the time of the inspection four people were being supported by the service.

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.

People’s experience of using this service and what we found

People continued to receive a good service. People were kept safe from harm by appropriately recruited and trained staff. Risks to people’s health and wellbeing were addressed and mitigated. People were supported with their medicines and to maintain cleanliness within their homes.

Staff were well trained and supported by their management team. Staff worked well with other health and social care professionals to enable good outcomes for people. People were supported to maintain a healthy and balanced diet. 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 cared for by staff who treated them with kindness, dignity and respect. People were supported to maintain caring relationships with people who knew them well. People’s independence was respected and encouraged as far as possible.

People received care which was person-centred and responsive to their needs. People knew how to make a complaint and felt confident they would be listened to.

Regular audits took place to measure the success of the service and to continue to develop it. People, staff and the registered manager described a culture which focussed on people and ensuring they received good care. Staff worked well with other health and social care professionals to support people.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure 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.

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.

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 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

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.

It was last inspected 29 April 2016 and we found that the provider was not always considering people’s capacity to make decisions for themselves. At this inspection we found that improvements had been made and people’s capacity had been assessed to make decisions. If they were not able to make their own decisions then they were made with people who were important to them in their best interest.

Quality systems were not always completed to ensure that the homes were well run. Some staff did not have the opportunity to attend team meetings to ensure they were providing a consistent approach to care.

People were kept safe by staff who understood their responsibilities to protect them. They were supported to make choices about their care and what they wanted to achieve. They planned their week to make sure they pursued their interests and did the activities that they liked. They had care plans in place to support this and they were involved in reviewing these regularly.

We saw that there were enough staff to support people and that those staff had been recruited following procedures to check that they were safe to work with people. They received training and support to ensure that they could support people well. We saw that they had positive relationships with people and that they used specialist equipment to assist people to make choices about their care. People were supported to make their own decisions about their care and support.

Risks to people’s health and wellbeing were assessed and actions were put in place to reduce them so that people could lead as independent lives as possible. Medicines were given to people safely and records were well maintained and managed. Staff supported people to maintain their health and to participate in managing their own wellbeing. We saw that people chose their own food and drink and were supported to have a balanced diet.

The manager was approachable and listened to people. This included responding to complaints and implementing actions from them.

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.

Staff had some awareness of the Mental Capacity Act 2005 MCA but the service had not assessed people’s mental capacity. The service had not kept records about this or consistently sought MCA assessments from the local authority.

Some people who used the service had a wide range of support needs, and required support from the service 24 hours a day. Other people were more independent and received support for just a few hours a day to help with their daily routines.

People were safe and staff knew what actions to take to protect them from abuse. The provider had

processes in place to identify and manage risk. People received care from a consistent staff team who were well supported and trained.

The provider had systems in place to support people to take their prescribed medicines safely.

People were supported with meals and to make choices about the food and drink they received. Staff supported people to maintain good health and access health care professionals when needed.

Assessments had been carried out and personalised care plans were in place which reflected individual needs and preferences. The provider had an effective complaints procedure and people had confidence that concerns would be investigated and addressed.

The service benefitted from a clear management structure. A range of systems were in place to monitor the quality of the service being delivered and drive improvement when necessary.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

We found medicines held within the home had arrangements in place that were satisfactory and would keep people safe.

Family representatives told us they could approach care workers and knew they would be listened to. They told us they were satisfied with the service provided.

We spoke with one relative they told us, 'staff understand my relative's needs and will keep me informed at all times of any changes. I think they are marvellous'.

We tried to obtain direct quotes from the people we met but we were unsuccessful. We saw them in their home environment and they looked to be comfortable in their surroundings.

We spoke with one relative who told us they had no concerns about their relative's diet. They told us, 'my relative manages really well considering their difficulties. I think staff has the right approach for them'.

One relative told us staff managed to give their relative their medications really well. They would give them their tablets then with the next spoonful they would be given some food and checked to see that it was taken.

When we arrived people were out either at the day centres' or out on other activities escorted by staff. We met people later on in the day.

We spoke with one relative they told us they were satisfied with the service provided, had no concerns because they regularly communicated with staff, found staff to be helpful in understanding their relative's care.