Archived: Voyage (DCA) South 2

This service provides care and support to people living in four ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. People lived in a range of houses and flats, some located in ordinary residential streets. The two homes we visited during this inspection were three and four bedroomed homes, with shared communal areas and a room where sleep-in staff slept at night.

At the inspection in April 2017 we rated the service ‘Requires Improvement’ overall. This was because we found recruitment practices did not meet required standards and we had not been notified of all safeguarding incidents occurring at the service as required by law. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key question ‘Is the service safe?’ to at least good. The provider told us their action plan would be completed by 26 August 2017.

At this inspection on 21 and 22 June 2018 we rated the service ‘Good’ overall.

Why the service is rated Good:

At our June 2018 inspection, we found improvements had been made to recruitment practices but checks where staff had previously worked in care needed to be more robust. Despite this, there was no impact on people’s safety as the systems in place to induct and monitor staff performance protected people from poor practice. Staff knew how to safeguard people from harm. We recommended that the service review recruitment processes for staff who had worked in care before. We found improvements to notifications to CQC had been met and sustained.

People’s needs had been assessed and their support requirements and preferences were recorded in detail to provide staff with the guidance they needed to support people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The service’s policies and systems supported this practice. Effective systems were in place to manage people’s medicines. When medicines errors occurred, staff underwent retraining and further competency checks. People were supported to access health care services and to maintain a healthy lifestyle.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Outcomes for people were good and they were supported to live as fulfilling lives as possible. People described their home as, “a happy home”.

Enough staff were available to ensure people’s well-being and for people to participate in activities safely. Staff understood people’s needs and completed appropriate training to enable them to meet people’s individual needs. Staff felt supported and well trained and had access to the guidance they needed to support people effectively.

The registered manager had been in post since March 2018. 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. They were registered to manage the service on 22 June 2018.

Effective quality monitoring and improvement systems were in place. The service had an open and progressive culture to improve people’s quality of life. People and their relative’s views were sought and acted upon if any concerns had been identified.

A registered manager was in place as required by their conditions of registration. 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 legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People had not been protected against the risks of employing unsuitable staff as safe recruitment and selection procedures had not always been followed. Staff knew how to recognise and raise concerns about people’s well-being but CQC had not been notified of all safeguarding incidents as required. The required notifications were made shortly after the inspection. Quality assurance processes were well established and provided oversight of the service. However, some shorftalls we found had not been identified through these processes.

People were supported by staff who received the support and training they needed to meet people’s needs effectively. There were enough staff to meet people’s needs with very occasional use of agency staff. Staff understood and cared about the people they supported.

People were supported to pursue their interests and aspirations. When this involved risks to them, these risks were managed so they did not miss out on exciting opportunities/activities. People's care and support was individualised and monitored to make sure care records reflected any changes in their health or well-being. People were supported to attend appointments with health care professionals and recommendations made by professionals were implemented. Staff responded well to emergencies and encouraged people to maintain a healthy diet and lifestyle.

People's rights were upheld and they were encouraged to make decisions about their day to day lives in line with the Mental Capacity Act 2005. If needed best interests' decisions were made on their behalf involving people important to them. People’s privacy and dignity was maintained by staff providing personal care. People were encouraged to express their views and their comments and complaints were taken seriously.

The provider’s values were upheld by staff who acted inclusively and with positivity. Where improvements were needed these were approached by managers with openness and resilience.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.