Linday Office

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Linday is a domiciliary care agency providing the regulated activity of personal care. At the time of our inspection there were 26 people using the service. The service provides support to adults of all ages, people with a learning disability and people with mental health needs.

Not everyone who used the service received personal care. 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.

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

Right Culture:

Audit systems in place had identified areas to improve the quality of the service. However, they had not been consistently implemented to maintain those improvements. People's needs and preferences were highlighted in their care plans for staff to follow. However, some care plans lacked detailed instructions for staff to follow regarding certain medical conditions. There were no reported missed calls, however there lacked some consistency from staff to inform people when they were running late. The registered manager understood their responsibilities. People's needs were assessed prior to them receiving care and support from the service.

Right Support:

Staff were recruited once they had cleared their security checks. Staff received training to support people safely. People were protected from the risk of abuse because staff knew their legal responsibilities to keep people safe. Risks to people had been assessed and people's care plans had been reviewed and updated. Staff supported people to maintain their health and wellbeing by accessing healthcare services.

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.

Right Care:

Staff understood how to promote people's independence and ensured the care they provided treated people with dignity and respect. People were supported to express their views. People's communication needs had been considered and met. Overall, people’s medicines were managed safely. The provider had sufficient infection, prevention and control measures in place and staff had access to a good supply of personal protective equipment.

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 inspection for this service was not rated (published on 1 March 2018).

The previously rated inspection was requires improvement (published on 17 December 2015).

Why we inspected

This inspection was in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection on 6 November 2015, we asked the provider to take action to make improvements to staff recruitment processes and quality assurance systems. The service sent us an action plan on how they would make the required improvements. At this inspection, we found the action plan had been completed.

The service had 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.

Risk assessments were in place and detailed actions to reduce identified risks to people to keep them safe. Staff understood how to recognise signs of abuse and how to protect people from the risk of abuse. They also knew how to report concerns appropriately to keep people safe from harm. Staff supported people to take and manage their medicines in a safe way.

The service checked that staff employed to work with vulnerable people were suitable to do so. Criminal records were checked and references were obtained before employees started work. There were sufficient numbers of staff deployed to meet people’s needs. Staff knew how to report incidents and accidents. Staff followed infection control procedures to reduce the risk of infection and contamination.

The service assessed the needs of people and developed support plans on how identified needs would be met. People’s individual needs were met. Staff cared for people in a way that met their requirements. People were involved in planning and reviewing their care. Staff supported people to access healthcare services. Staff were supported through induction, supervision and training to provide appropriate care to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People consented to their care before they were delivered. Staff and the provider understood their responsibilities within the Mental Capacity Act 2005.

People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. Staff supported people to do their food shopping and to prepare meals.

People told us staff treated them with kindness, compassion and respect. People’s dignity and privacy was respected by staff. People knew how to raise their concerns and complaints about the service.

The provider had improved the way they audited the service. People and staff told us that the managers listened and acted on their views about the service. Staff received the direction and guidance to do their jobs. The service worked in partnership with other organisations to meet the needs of people.