QRC Dom Care

Updated 8 February 2020

The inspection:

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.

Inspection team:

This comprehensive inspection was carried out over two days by one inspector.

Service and service type:

This service is registered as a domiciliary care agency. It provides personal care to people living in their own houses and flats or shared accommodation with others. Most people receiving personal care are living in a ‘supported living’ setting, 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not present during the inspection as they were on long term planned absence which CQC had been notified of appropriately. In their absence the service was being managed by the service co-ordinator, and we have referred to them throughout this report as “the acting manager”.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 20 November 2019 and ended on 22 November 2019. We visited the office location on 20 November 2019 and visited people in their homes on 21 November 2019. Calls to people’s relatives were made after the site visit.

What we did before the inspection:

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch, which is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all of this information to plan our inspection.

During the inspection:

We spoke with three people who used the service to obtain their feedback about their experience of the care provided. We spoke with four members of staff including the acting manager, senior care staff and support workers.

We reviewed a range of records. This included seven people’s care records and medication records for three people. We looked at four staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, quality assurance reports, meeting minutes, policies and procedures were reviewed.

After the inspection:

We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies and quality assurance records. We contacted seven relatives about their views of the care provided. We had contact with six professionals who had experience working with the service.

Updated 8 February 2020

About the service

QRC Dom Care is registered to provide personal care for adults, some of who may be living with a learning disability or other complex conditions such as autism spectrum disorder. People supported by this service either live in their own homes, or in shared accommodation with others. 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 the time of the inspection there were 25 people being supported with their personal care delivered from several supported living sites.

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

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.

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.

The service was exceptional in encouraging people to live as full a life as possible and supported them to achieve the best possible outcomes. People's confidence, independence and wellbeing had improved since they began using the service. Several relatives told us being supported by the service had been lifechanging for their loved one.

Staff were passionate about ensuring people had access to a wide range of personalised and group activities and were supported to have a say in all aspects of how the service was delivered. People were supported to have as many opportunities as possible, and staff were dedicated to supporting people gain new skills and live more independently.

People received personalised care that was exceptionally responsive to their needs. People were genuinely encouraged to express their hopes and dreams and the service looked for innovative ways to make these a reality. Staff knew people especially well and used this knowledge and support them to achieve their goals. People's achievements were recognised and celebrated.

Staff had formed genuine, positive and warm relationships with the people they supported and looked for ways to make them feel valued. Staff were creative and looked for inclusive ways to ensure all people's views were sought out and acted upon.

The service was exceptionally dedicated to making sure people were enabled to maintain relationships with those who mattered to them. Their relatives described staff as wonderful and amazing and professionals described the staff as knowing people especially well, and the management as being experienced, knowledgeable, very responsive and compassionate.

People's health and wellbeing was closely monitored to ensure they received timely and appropriate treatment.

People were supported by staff who had been recruited using safe and robust processes, and who had comprehensive knowledge and were supported to develop their skills to fully meet people’s needs. There were enough staff to meet people's needs in an inclusive way.

People were supported by a consistent staff team who were aware of the risks to people and knew how to manage these safely. People were supported to take positive risks to promote their independence.

Staff were aware of safeguarding procedures and knew the correct action to take if they suspected abuse had occurred. Medicines were administered, stored and disposed of safely and people were supported to manage their own medication where they could. Infection control practices were robust.

Staff were always considerate of people's feelings and treated people with the utmost respect and dignity. People were supported in a way that enabled them to have an excellent quality of life.

People had enough to eat and drink and where people were nutritionally at risk this was identified, and people were supported appropriately with input from professionals when needed.

Staff understood and knew how to help people make decisions and give their consent to treatment with reference to the appropriate legislation. 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. Where restrictions were in place this was in line with appropriate guidelines.

People benefitted from a service that had a dedicated registered manager whose experience was used to support people to lead truly full and meaningful lives. Robust quality assurance processes ensured the safety, high quality and effectiveness of the service. The values of the provider were consistently demonstrated by staff in their interactions with people and with each other.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection:

The last rating for this service was Good (report published 22 February 2017)

Why we inspected:

This was a planned comprehensive inspection scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

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.