We carried out a review of the data available to us about QRC Dom Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about QRC Dom Care, you can give feedback on this 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.
On the day of our inspection there was registered manager in place. 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.
People were supported by staff to feel safe within their home. People were supported by staff who could identify the different types of abuse and who to report concerns to. Assessments of the risks to people’s safety were in place and regularly reviewed. This included how to evacuate people from their homes in an emergency. There were sufficient numbers of suitably qualified and experienced staff in place to keep people safe. Safe recruitment processes were in place. People’s medicines were managed safely.
Staff were well trained, received regular supervision and felt supported by the registered manager. The principles of the Mental Capacity Act 2005 (MCA) were not always considered when decisions were made for people. People were supported to plan, buy and where able, to cook their own food and were encouraged to follow a healthy and balanced diet. People’s day to day health needs were met effectively by the staff. Healthcare professionals spoke positively about the way staff supported people with their day to day health needs.
Staff spoke respectfully about people and relatives felt they were kind and caring and treated their family members with respect and dignity. Where able, people were involved with decisions made about their care and support, with relatives and professional input included where needed. Information was available for people if they wished to speak with an independent advocate and we saw one had been used to support a person with making a specific decision. People were supported to live as independently as they wanted to.
People were supported to take part in the activities that were important to them; this included attending college or finding employment. People’s support records were person centred, focused on what was important to each person and provided staff with relevant information to respond to people’s needs. A robust pre-admission assessment was carried out to ensure new people’s needs could be met. No formal complaints had been received, but processes were in place to respond to them effectively if they were.
A person who used the service, relatives, staff and health care professionals all spoke highly of the registered manager. A number of systems were in place that enabled a wide range of people, staff and relatives to give their views about the service. Staff, including the registered manager had a clear understand of their roles and responsibilities. Robust quality assurance processes were in place.
We found that people's support plans and risk assessments were reviewed regularly and updated when changes were identified.
A relative told us, "This agency provides excellent care, I cannot fault them, the care workers are caring, knowledgeable and patient". Another relative said, "The staff are lovely and kind, the quality of care is very good".
We found that the service had an effective recruitment process in place. The staff were subjected to essential criminal and reference checks, and followed a comprehensive induction and training programme. One member of staff told us, "My induction was very thorough, I had to shadow senior staff and complete an induction pack to demonstrate my competence before working by myself. With this and with all the training we get, I have learned a lot".
We found that staffing levels were planned according to people's levels of dependency and that there was enough staff to meet people's needs. A member of staff told us, "There are enough of us, we meet the residents' needs".
We found the service had an appropriate complaint policy and procedures in place. People who used the service and their relatives or representatives were aware of how to make a complaint. One person said, "We know how to complain but quite honestly it never comes to that, if we have any concerns we just discuss it with the keyworker, or the service co-ordinator or the manager and it gets sorted straight away".
We saw that the services' records were accurate, regularly updated and fit for purpose. We found appropriate documentation was kept in relation to people's care and finances, staff, policies, surveys and audits. There was an effective system for the storage, archiving and disposal of records that met legal requirements.
The people we spoke with told us they were happy with the care that their relatives had received and with the staff team. A relative of a person who used the service told us 'Our son is so happy and he is really looked after'. Another relative of a person who used the service we spoke with told us 'He is very happy actually and they support him well'. Staff that we spoke with had a good understanding of the support needs of the people who used the service. One member of staff told us 'I feel that we support people to be independent, we only support them with what they need, when they need it'.
During our visit, staff we spoke with confirmed that they had felt supported and had received relevant training, which had included the safeguarding of vulnerable adults. We saw that the service had ensured that staff were able to deliver care and treatment safely through regular training and assessments. The service had quality assurance systems in place to monitor the quality of the service provided and to gain the views of the people who used the service.