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Archived: H C S Domiciliary Care Good


Inspection carried out on 10 and 11 December 2015

During a routine inspection

This inspection took place on 10 and 11 December 2015 and we gave the provider one days’ notice that we would be visiting the supported living project and office. The inspection was carried out by one inspector over two days. At our last inspection on 9 May 2014 the service was meeting all of the standards we looked at.

H C S Domiciliary Care provides personal care to people living at two supported living projects in Enfield. There are two residential houses next door to each other. Each person has their own room and they share communal lounges, a kitchen and laundry facilities. At the time of our inspection there were 12 people using the service. Staff provide support to people that is either on a one to one basis or one staff is shared between two people. The project is staffed 24 hours.

There was a new manager in post at the time of our inspection who has applied to be registered with the Care Quality Commission. 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 and associated Regulations about how the service is run.

People told us they were well treated by the staff and felt safe and trusted them.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified, the management had thought about and discussed with the person ways to mitigate risks.

People told us there were enough staff to support them properly.

The service was following robust recruitment procedures to make sure that only suitable staff were employed at the supported living projects.

Staff we spoke with had a good knowledge of the medicines that people they supported were taking. People told us they were satisfied with the way their medicines were managed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities and staff told us that they were provided with training in the areas they needed in order to support people effectively.

Staff understood that it was not right to make choices for people when they could make choices for themselves and people’s ability around decision making, preferences and choices were recorded in their care plans and followed by staff.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The service had a number of quality monitoring systems including yearly surveys for people using the service, their relatives and other stakeholders. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.

Inspection carried out on 09/05/2014

During a routine inspection

H C S Domiciliary Care provides a personal care service to people with learning disabilities. At the time of our inspection, a service was being provided to ten people at their supported living placement and 16 people at their day centre. An outreach service was provided to two additional people.

The service had a registered manager in place as required. They had worked for the provider for a number of years and had been the registered manager for the past three years.

People who used the service had mild to severe learning disabilities. We were able to have brief conversations with some people who used the service, and spoke to five relatives of people who used the service.

Relatives of people who used the service told us they trusted the staff to keep people safe. Staff were knowledgeable in recognising signs of potential abuse and reported concerns appropriately to the local authority. We saw that the service had responded appropriately to an incident of abuse and taken appropriate action to protect people. However, we saw the provider had not notified us as required of one allegation of abuse.

Individual support plans were developed with people who used the service and their relatives. These plans contained detailed information about what people were able to do for themselves and where they required support. Information was obtained about people’s interests and their preferred daily routine. We saw that care and support was delivered in line with this.

When people’s support needs changed good communication within the staff team ensured they received a safe service that was tailored to their needs. Staff supported people to access health services, for example, their GP, their dentist or optician, to ensure their primary health needs were met and accompanied them to specialist appointments at the hospital when required.

Staff were patient and polite when supporting people and we observed positive interactions between the staff and people who used the service and their relatives. People who used the service told us they liked the staff, and relatives of people who used the service told us staff were kind and caring.

People were involved in decisions about their care if they were able to. If they did not have the capacity to make those decisions, ‘best interests decisions’ were made by their relatives together with health and social care professionals involved in their care.

Staff reported there was good leadership and management of the service, with good access to senior colleagues for further advice and support. They felt supported to raise concerns and were confident that the manager acted upon any concerns raised. However, we found at the time of our inspection that the provider did not have a system in place to review incidents centrally to identify any trends or patterns of concern.

Inspection carried out on 7 June 2013

During an inspection to make sure that the improvements required had been made

We did not speak with people using the service as the focus of the inspection was to check that specific improvements had been made by the provider since our previous inspection on 21st February 2013.

Staff received appropriate supervision and appraisals. Some training courses were recorded as being overdue since the previous inspection but staff told us and we saw records that showed that these were being programmed. This meant that staff were appropriately supported.

We saw that people's personal records including medical records were mostly kept up to date. Staff records included training certificates. Records were stored in accordance with the Data Protection Act 1998. This meant that accurate records were being maintained.

Inspection carried out on 21 February 2013

During a routine inspection

A relative we spoke with about the service said �it�s nice. He�s happy.� Opportunities were made for people to go shopping and to the pub, the daycentre and trips further afield such as Covent Garden and the seaside. Relatives were very involved and often gave feedback to the manager, whom they described as responsive and approachable. People using the service were involved and treated with respect.

People�s support plans were largely in place and up to date. Individual risk assessments had been made and people using the service were protected from the risk of abuse because of the steps taken by the provider.

Staff received appropriate supervision but no appraisals had been held and several training courses were recorded as being overdue. Different records of training received meant that the manager could not be sure that staff were equipped to deliver care safely to people using the service.

The provider had an effective system to monitor the quality of service people received. However, records relating to people using the service, staff and other management records were not accurate or fit for purpose. Neither could they be located promptly when needed. This lack of proper information meant that people were not fully protected against the risks of unsafe or inappropriate care.