Royal Mencap Society - Hull Domiciliary Care Agency

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

People continued to be protected from avoidable harm and abuse by staff who were able to identify and follow processes to raise concerns. Staffing levels were safe and recruitment processes helped ensure only suitable people were employed. The provider followed their disciplinary processes appropriately. People were protected from the spread of infection and their medicines were administered safely. Accidents and incidents were analysed to identify patterns and personal information was stored securely.

Staff had the skills and knowledge to provide effective care and enable people to achieve positive outcomes. Learning and best practice was embedded through supervision and appraisals. People were supported to eat a healthy, varied diet of their choice and were supported to access relevant health care services.

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 supported this practice.

Staff treated people like family and were kind, caring and passionate about the support they provided. People’s privacy and dignity was respected and they were supported by a regular group of staff that enabled trusting relationships to be built. Staff communicated with people appropriately and valued people as individuals.

People were supported to lead fulfilling lives through going on holiday and pursuing their interests in the local community. Staff challenged discrimination and people were supported to have pain-free, dignified deaths. Policies and procedures were in place to respond and address complaints.

There was an open and honest culture, new ways of working were encouraged and staff were praised for positive work. People and their relatives were included in the development of the service and the provider worked with local community and organisations.

Staff had received specific training though some training dates had lapsed. Care plans were person-centred but information from reviews was not always included in them. Systems were in place to maintain quality in the service, however, these were not being used effectively. We have made a recommendation about this.

Further information is in the detailed findings below.

This inspection took place on 9 March 2016 and was announced. The registered provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. We also visited people in their own homes on the 14 march 2016. The service was last inspected in June 2014 and was found to be compliant with the regulations inspected at that time.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Due to the complex communication needs of the people who used the service we were unable to ask them their views about the service so we visited them in their homes to observe how staff supported them. We saw staff were kind and caring and respected their wishes. We saw staff supporting people with eating their meals and undertaking visits into the community. Staff told us they found the work they did challenging but very rewarding and satisfying as they helped people to maintain their skills and lead a fulfilling life, for example, supporting people with holidays and further education. Staff told us, “I find this work very rewarding as we become friends with the people we care for”, “The people we care for are really nice we get all get on so well, it’s like an extended family” and “I love doing this job it’s so nice to come to work.”

Staff had received training in protecting people from harm and could recognise if someone was being abused. They knew how to report any abuse they may witness to the proper authorities so people were protected from harm. The registered provider had systems in place which ensured any new staff recruited were checked to make sure people were not exposed to staff who had been barred from working with vulnerable adults. Enough staff were provided so people were supported to pursue hobbies and interests and could access the local community to attend educational facilities.

People who used the service were cared for by staff who had received training in how to best meet their needs. People who needed support with making informed decisions and choices were protected by the use of legislation which protected their human rights. Staff supported people to eat a varied balanced diet and to lead a healthy lifestyle. People were supported to visit health care professionals when they needed to and staff ensured they followed their instruction with regard to any further treatments or support plans.

People were supported by staff who were kind and caring and who understood their needs. Staff had a good knowledge of people’s likes and dislikes and these were accommodated. Staff respected people’s right to privacy and upheld their dignity. People who used the service or their advocates were involved with the formulation of care plans which instructed staff how to best support the person.

Staff had access to information which described the person and how they preferred to be supported so their personal needs could be met. This information included aspects of daily life which may pose a risk to the person so staff could keep them safe if they were a risk to themselves and others. People were supported to access the local community and to use local facilities so they could pursue their individual hobbies and interests. Staff supported people to access educational facilities to undertake training and gain further life experiences. People were supported to go on holidays abroad and in Britain.

The registered manager had systems in place which sought the views of the people who used the service and other stakeholders who had an interest in their welfare. Audits were in place to ensure the service was well run and people were cared for appropriately and were safe. Staff were supported by the management team to ensure they met the needs of the people who used the service effectively.