The Field Lane Domiciliary Agency

The Field Lane Foundation is an organisation that provides supported living services and a domiciliary care service for people in their own homes or in support living schemes. People who used the service were adults living with a learning disability and/or autism, some of whom also had needs with their mobility such as a physical disability or a condition such as epilepsy. On the day of our visit, the service was providing support and personal care for 63 people with varied care packages in a variety of settings. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating.

People received care in their own homes, in their own self-contained flats and people received care who were living in supported living houses where six people or less lived.

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 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 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.

We observed positive, friendly interactions between people and staff. Staff spent time with people as and when they wanted. Staff respected people and focussed on increasing their independence and achieving good outcomes. People were treated with dignity and kindness. People were supported to learn new skills and succeed in their goals.

People received personalised care that was tailored to meet their individual needs, preferences and choices. Person centered care plans were detailed and guided staff about people's needs and how to meet them. Staff supported people to make choices and decisions relating to their care and to live their lives as they wished.

Relatives we spoke to were satisfied with the quality of care. A relative told us, “Overall my relative has expressed he’s happy, {the support given] has been instrumental in building my relatives confidence. Another relative said, “I’m satisfied it’s a high level of care that my relative receives, my relative seems happy and “I’m confident.”

People were safe and were supported by staff who were trained to recognise the signs of any potential abuse. Staff had been trained in safeguarding and knew what action to take if they had any concerns about people's safety or welfare.

People's risks were identified and assessed appropriately such as accessing the community, mobility, travelling in the car and road safety.

There were sufficient staff to meet people's needs and to enable them to engage with activities, access the community and to live their lives independently. People were supported by staff whose suitability was checked at recruitment. Staff completed training and were experienced in their roles to provide effective care to people. Staff received regular supervisions and an annual appraisal.

People were comfortable in the company of the support workers. Staff felt supported by the managers and felt confident that any suggestions or concerns would be listened to and acted upon. People were asked for their feedback about the service through house meetings and giving feedback to staff. A range of quality assurance systems measured and monitored the quality of care and the service overall.

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 23 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Field Lane Domiciliary Agency on our website at www.cqc.org.uk.

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 and associated Regulations about how the service is run. The registered manager and the nominated individual were present for the duration of the inspection.

The service’s risk assessment process enabled people to take risks as safely as possible. The risk assessments identified risks and provided guidance for staff to manage these safely without compromising people’s independence.

Arrangements for the administration of medicines were in place which ensured that people received their medicines safely and in an appropriate way.

Staff recruitment processes were safe. Appropriate checks, such as a criminal record check, were carried out to help ensure only suitable staff worked in the service. Staff met with their line manager on a one to one basis to discuss their work. Staff said they felt supported and told us the registered manager had good management oversight of the service.

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

Staff were aware of their responsibilities regarding safeguarding people from abuse and were able to tell us what they would do if they suspected abuse had taken place. They had access to a whistleblowing policy should they need to use it.

People’s privacy and dignity were respected. Staff were professional and polite and addressed people in an appropriate manner. Gender specific staff were provided for people who made a specific choice and people’s information was handled confidentially.

Staff supported people to keep healthy by encouraging them in their choice of nutritious foods. People were either supported or supervised in their menu planning and shopping.

People had access to health care professional and staff supported people to have regular health checks and to attend appointments and clinics as appropriate. When people lived with behaviour that challenged they had the support of clinical experts for advice and guidance.

People were encouraged to take part in a range of activities which were individualised and meaningful for them. People planned their day with help from staff and this was flexible depending on how people felt or other activities available.

Staff had followed legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

There were sufficient numbers of staff provided to meet people’s needs and support their activities. People and staff interaction was relaxed. It was evident staff knew people well and understood people’s needs and aspirations. Staff were very caring to people and responded well to people’s care needs.

The registered manager and project managers undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were actioned by staff.

If an emergency occurred people’s care would not be interrupted as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was available in a format that was easy for people to understand. People and their relatives were encouraged to feedback their views and ideas into the running of the service.

Records management was good and showed the service and staff practice was regularly checked to ensure it was of a good standard.