22 October 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection was completed by one inspector, two medicines inspectors and two Experts by Experience undertook the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The registered manager had left and was in the process of deregistering with CQC. A new manager started during the inspection and had applied to be registered with CQC. This meant that the provider was legally responsible for how the service is run and for the quality and safety of care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the management team would be in the office to support the inspection.
What we did before the inspection
Prior to the inspection we looked at a range of information we held about the service. This included feedback, investigations and statutory notifications which providers are required to send to us by law. We also asked for feedback from professionals who had knowledge of the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
The inspection site visit took place on 8 September 2021 and feedback was provided on 24 September 2021. We visited the office as well as, with permission, four addresses where people using the service lived. We spoke with 12 people who used the service and 21 family members. We also spoke with 11 staff members, these included care staff and tenancy managers as well as the regional manager who was responsible for the operation and management of the service. We also asked for feedback from staff via email and received four responses. We received feedback from three professionals.
We reviewed a range of records. This included the care records for five people, 12 medicines records and related documentation, staff recruitment files, training records and supervision, and records relating to the operation and oversight.
After the inspection
We continued to receive information to support the inspection process.
22 October 2021
About the service
West Lanc's Domiciliary Service is a domiciliary care service providing personal care and supported living to people in their own homes. There were 46 people receiving care from the service at the time of the inspection. All of the houses where people lived were located locally to the providers location address.
People’s experience of using this service and what we found
Medicines were being managed safely, we made a recommendation in relation to staff competency checks. People told us they were safe and investigation into allegations of abuse had been completed. Safe recruitment was taking place. The regional manager told us there was an ongoing recruitment programme. Some people told us more staff were required in the tenancies.
Training and supervision was ongoing however the training matrix identified some training had not been undertaken for some time we made a recommendation in relation to training. The regional manager confirmed they would review the training matrix to ensure it was up to date. Relevant capacity assessments had been completed. People, relatives and the records we looked at confirmed they had been reviewed by relevant professional to support their needs.
People received good care, feedback from people, relatives and professionals was positive about the care provided. Staff understood the importance of the care they provided.
Care plans had been completed, the regional manager confirmed that they would take action to ensure reviews were completed to ensure they were up to date. Activities were taking place however these had been impacted since the COVID-19 pandemic. Complaints were being dealt with, positive feedback was seen.
All of the staff team were supportive of the inspection and information was provided promptly. People were positive about the management team, however some feedback from staff was that they were burnt out. The regional manager confirmed their plans going forward to make improvements with the new manager who had applied to register with the Care Quality Commission. A range of audits was taking place, team meetings and questionnaires had been completed however people confirmed these had not occurred for some time.
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. We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The model of care and setting maximised people’s choice, control and independence. Care was person-centred and promoted people’s dignity, privacy and human rights. The values, attitudes and behaviours of leaders and care staff ensured people lead confident, supportive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was good (published 8 December 2017)
Why we inspected
This was a planned inspection based on the previous rating.
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.