This inspection took place on 2 & 3 February 2016. We gave the provider 48 hour notice before we carried out the inspection to ensure we could access the information we needed.
Hertfordshire Domiciliary Care Agency provides personal care and support to people in supported living schemes. The service was used by 13 people with learning disabilities, mental health and autistic spectrum disorders in six supported living locations. The service has not been inspected since it had registered on 3 June 2014.
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 2008 and associated Regulations about how the service is run.
People were supported by staff who were knowledgeable in safeguarding procedures and how to report concerns of abuse internally and externally to safeguarding authorities.
People were supported to understand the risk associated with their daily activities and encouraged to take positive risks and live an active life.
There were sufficient numbers of qualified and skilled staff to meet people`s needs at all times. Recruitment procedures were safe and effective and ensured that staff employed to support people were fit for the role.
People were supported to take their medicines by staff who were trained in the safe handling of medicines and their competency was regularly reviewed.
People`s consent for the support they received was constantly sought by staff using various communication methods to ensure people understood what they were consenting too. Their consent to the support they received was also recorded in their support plans.
The Mental Capacity Act (2005) provides a legal framework for making particular decisions on behalf of people who may lack mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. Where they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working in line with the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that the service was working in accordance with MCA requirements.
People told us staff was kind and caring in their approach and treated them with respect. Staff promoted people`s dignity and respected their privacy.
People had the opportunity to regularly review their support needs and where it was a need for it people`s relatives and care coordinators were involved to ensure the support was meeting their needs.
People were encouraged and supported to pursue their hobbies and interests and be actively involved in the community.
The provider actively sought people`s views on the service in regular house meetings and in addition they sent annual questionnaires to people using the service, staff, health and social care professionals and relatives. The results were analysed and a service improvement action plan was developed to ensure improvements were made to the service provision.