Jubilee Domiciliary Care Agency

About the service

Jubilee Domiciliary Care Agency is a domiciliary care agency providing personal care to 1 person at the time of the inspection.

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

Right Support:

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff enabled people to access specialist health and social care support in the community.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and had plans to personalise the décor in their home to suit their taste. .

The service made reasonable adjustments for people so they could be fully in discussions about how they received support, including support to travel wherever they needed to go. Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.

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:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Staff understood how to protect people from poor care and abuse. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

Right Culture:

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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 requires improvement (published 14 March 2019).

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

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

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

Upon finalisation of the report we have been made aware that the domiciliary care provider had changed office address but we had not been notified. Whilst this does not impact on the quality of care delivered, and therefore the report remains relevant, it is a breach of condition of registration. The provider is working to resolve this issue and has now made the necessary application to CQC.

About the service: Jubilee Domiciliary Care Agency is a domiciliary care agency that provides personal care to people living in their own homes in the community. It provides a service to youngers adults, with a learning disability or an autistic spectrum disorder. At the time of this inspection, the service was providing personal care to four people in two properties.

People’s experience of using this service:

• People were not always protected against the risk of fire as the registered manager failed to take sufficient and swift action of issues identified.

• Communication between management was not always as effective as it could be. This meant that issues identified were not always acted on in a timely manner.

• People continued to be protected against the risk of abuse, as staff received safeguarding training, knew how to identify, respond to and escalate suspected abuse.

• Risk management plans in place were robust and enabled staff to keep people safe from avoidable harm. Risk management plans were reviewed regularly to reflect people’s changing needs.

• People received their medicines as intended. Issues identified were acted on in a timely manner to minimise the risk to people. People continued to be protected against the risk of cross contamination, as the provider had developed comprehensive infection control policies.

• People continued to receive care and support from suitable numbers of staff that had gone through a rigorous pre-employment check. Staff training was person specific and enhanced staff members’ skills and knowledge. Staff reflected on their working practices through regular supervisions.

• Staff had sufficient knowledge of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People’s consent to care and treatment was sought, documented and respected.

• People continued to have access to food and drink that met their dietary preferences and needs. People were supported to access a wide range of healthcare professionals to monitor their health and well-being.

• People received support from staff that were compassionate, treated them with respect and encouraged their independence where assessed as safe to do so. People’s dependency levels were regularly reviewed to ensure support provided reflected their needs.

• People received person-centred care that reflected their wishes, health, medical and social needs. People and their relatives were encouraged to develop their care plans which were regularly reviewed.

• People continued to be supported to raise concerns and complaints and were confident action taken would be swift.

• The service carried out regular audits to drive improvements. People’s views continued to be sought through regular quality monitoring checks. Issues identified were acted on in a timely manner.

• The CEO confirmed the management structure within the service had been reviewed and changes implemented to improve the quality of the service and experience people received.

• The management team actively encouraged partnership working with other health care professionals. Records confirmed, guidance provided was put in place.

Rating at last inspection: The service was previously inspection on 7 June 2016 and was given an overall rating of Good.

Why we inspected: This was a planned inspection in line with our inspection programme.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

Jubilee Domiciliary Care agency provides supported living for three people who all live in one property. At the time of our inspection the service was providing support to three people. The service is run and supported by the same registered manager and staff of another nearby service 20--22 Lincoln Close 220-21-22 Lincoln Close 20-21-22 Lincoln Close 0-21-22 Lincoln Close

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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.

People told us they felt safe and happy. Staff were clear on their role in supporting people to have independence and control over their lives while promoting their safety, comfort and wellbeing. People said they were supported to plan a healthy balanced diet and were supported in their physical and mental health needs.

Staff had received training in how to safeguard people from abuse and knew how to report concerns. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced.

There was a strong emphasis on providing care which focused on the individual. People told us they were fully involved in planning their care and they were encouraged to develop their skills and interests. There were clear plans on how people wished to be supported and the goals they wanted to achieve. The service was flexible and responded positively to changes in people’s needs.

People were positive about the skills, experience and abilities of the staff who supported them. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

Staff developed positive and caring relationships with the people they supported. People told us that support was provided in a way that promoted their dignity and independence and respected their privacy at all times.

Jubilee Domiciliary Agency was well led by a manager who knew the people who used the service and supported them to have their views and ideas heard and acted upon. People who used the service and staff were very complimentary about the registered manager and how the service was operated. Effective arrangements were in place to monitor risks and the quality of services provided.

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We looked at records which showed that people's care and support needs had been assessed, documented and reviewed. They were personalised and gave staff clear guidance on how to meet people's individual needs and requirements. A social care professional with recent experience of the service told us, 'It's a good quality service that provides good quality support. They [staff] are very competent with support plans and risk assessments. I have no concerns about the service.'

Records showed that effective recruitment procedures were in place which ensured that staff were fit, able and properly trained to meet people's needs. This included carrying out appropriate checks before staff began work. We also saw that the provider had taken appropriate steps to ensure there were sufficient numbers of suitable staff to meet people's needs.

Systems had been put in place to regularly assess and monitor the quality of services provided at the home.

The agency provided care and a housing association provided accommodation and maintenance of the property. People who used the service signed both a tenancy agreement and a contract for their care. Through the care agency's yearly quality monitoring surveys, people indicated their satisfaction with the service.

Records and care plans that we saw were detailed, up to date and contained elements that showed people's involvement in their care.

People indicated in the surveys that they felt safe. They also stated that they were making their own decisions and were supported by their key workers (a staff member designated to focus on a particular person). A person wrote: 'I would let my key worker know if anything was wrong.'

We saw that the provider had appropriately dealt with a safeguarding issue in November 2012. They involved the safeguarding authority and informed us, as the regulator, of all the actions they had taken to ensure the protection of people.