Darwin Community Support

Darwin Community Support provides personal care for people as part of a domiciliary care scheme. Everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At this inspection, they were providing a regulated activity for 27 people.

Darwin Community Support care staff supported people with a physical disability, those with a learning disability, older people with dementia, people with mental health problems and younger adults.

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 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 felt involved in the care and support they received which was personal and individual to them.

The provider had developed a culture where all staff encouraged people to explore their care and support options.

People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability. The provider had embedded the equality, diversity and human rights approach to supporting people's privacy and dignity. People had very positive outcomes as a result. The provider fully understood people's individual needs and delivered care and support in a way that meets these.

Darwin Community Support made arrangements for people to engage in social activities, education and work, which were innovative, met people's individual needs, and followed best practice guidance so people could lead as full a life as possible.

The service knew what people have done in the past and what they wanted to achieve in the future. They evaluated whether they could accommodate people's desired activities and strived to make them happen.

The service had a very flexible approach to any restrictions imposed on people; keeping them under constant review, making them in a time-limited way, and only when necessary.

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 at Telford and Wrekin Shared Lives Scheme supported this practice.

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

The provider promoted a strong organisational commitment to achieving positive outcomes for people. This was evidenced through quality monitoring processes. The provider, and management team, had good links with the local communities within which people lived. The management team and provider had systems in place to identify improvements and drive good care.

The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. This helped people who use the service to 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 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.

People received safe care and support as the staff team had been trained to recognise potential signs of abuse and understood what to do to safely support people. The provider had assessed the risks to people associated with their care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm to people. When it was needed, people received safe support with their medicines by trained and competent staff members

People had access to additional healthcare services when required. Staff members knew people's individual health outcomes and supported them appropriately. When required, people were supported to maintain a healthy diet by a staff team which knew their individual preferences.

People received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were provided with information in a way they could understand.

The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.

Rating at last inspection

The last rating for this service was 'Good' (report published 06 June 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 reinspection programme. If we receive any concerning information we may inspect sooner.

The inspection of this service took place on 12 and 13 April 2017 and was announced.

There was a registered manager in post and they were present at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, registered managers 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 had been involved in identifying and assessing hazards and risks associated with providing their support. However, we found that some known risks had not always been managed safely to protect people from harm.

Risks had not always been properly assessed and guidance that had been put in place to protect staff was, on occasion, ineffective. In addition, staff did not always have the skills or back up to offer safe support.

Staffing issues had created challenges for the agency and at times had compromised people’s safety. Overall, people felt that staffing levels were improving although some people were not receiving consistent support from a dedicated team who knew them well. This meant that the quality of care was compromised.

People were not always protected against the risks associated with medicines because staff were not always confident to manage processes safely. Policies, procedures and training required improvement to reflect the domiciliary type service provided.

People were supported by staff who knew how to keep them safe and free from abuse. Staff knew how to recognise and report concerns, problems or signs of potential abuse. The registered manager and staff team worked effectively with outside agencies to keep people safe when required.

People were supported by staff who had the basic knowledge and skills to provide effective support and further training about specialist conditions is being arranged. The registered manager was actively reviewing this issue and addressing this shortfall. Staff were recruited through safe recruitment practices meaning that only people suitable to work in the role were appointed.

People’s rights were protected under the Mental Capacity Act 2005 and people were supported to make choices in relation to the care and support they received. Staff respected people’s decisions and they supported people to ensure decisions made were in the person’s best interests.

People received the appropriate amount of support to enable them to enjoy a varied and balanced diet. People’s independence was promoted and staff worked with healthcare professionals to promote people’s good health.

People were supported by staff who were caring and kind. People were listened to and consulted making them feel involved and in control of their care and support. People told us they were supported to remain as independent as possible and staff respected people’s privacy and dignity.

People received a responsive service that reflected their individual needs and wishes. Staff were knowledgeable about people’s support requirements and could offer flexible support as people’s needs changed. People remained at the heart of the service provided. Care plans reflected individualised support packages that focussed on meeting people’s assessed needs and their aspirations for the future.

People knew how to raise concerns and felt confident that the registered manager would listen to them. Relatives had mixed experiences of complaints effecting change although they all thought the investigation process was thorough and that they were listened to.

People told us that they were regularly asked if they were happy with the service provided. They had opportunities to be involved and consulted in the running of the service and felt that their views and ideas were listened to and acted upon to ensure the service they wanted reflected the one they received. Overall staff also felt listened to and consulted.

Systems and processes were regularly audited and outcomes were acted upon to improve the quality of the service. Not all systems and processes reflected a domiciliary type service and the registered manager was liaising with the provider to address this.

People experienced care, treatment and support that met their needs and protected their rights. One person who used the service said, 'They look after me well.' Another person said, 'I get on well with all my carers, I like them.'

We found that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify potential abuse and acted appropriately.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The staff members we spoke with said that they felt supported.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

People told us that their views were listened to and respected. The provider held regular group meetings for the people it supported.

We found that care plans were written in a way that focussed on people's abilities and emphasised the importance of encouraging independence. We saw that people had independence milestones and that staff were working with people to achieve them.

We saw staff treating a distressed person with sensitivity and tact. People told us that staff were always respectful. We found that care plans contained all the information staff required to deliver the care people needed.

We found that the provider had a comprehensive safeguarding policy in place. Staff were familiar with the policy.

We also found that appropriate checks were properly carried out on staff before they were allowed to start work.