We carried out a review of the data available to us about DHR Support Services Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about DHR Support Services Ltd, you can give feedback on this service.
DHR Support Services Ltd is a domiciliary care service providing personal care to people living in their own home in the community and within supported living projects. At the time of the inspection the service was supporting people with a learning disability and autistic people and people with a mental health condition. The service was supporting three people at the time of the inspection.
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
People were happy and content with the care and support they received from DHR Support Services Ltd.
Relatives of people using the service spoke positively of the service and the care and support that their family member received, stating that the service worked in partnership with them and their family member ensuring their needs were appropriately met.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and setting maximises people’s choice, control and independence. Care is person-centred and promotes people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
We observed people interacting with support staff in ways which assured us that people felt safe and were happy in the ways in which they were supported. Staff knew the signs to look for if abuse was suspected and told us of the actions they would take to protect people from abuse.
Support plans detailed people’s identified risks associated with their health and care needs, with clear guidance to staff on how to manage those risks to keep people safe.
Policies and systems in place gave assurance that people’s medicines were managed and administered safely ensuring people received their medicines as prescribed.
We observed sufficient numbers of staff available to assist people with their assessed needs. Recruitment processes ensured that only those staff assessed as safe to work with vulnerable adults were employed.
Support plans were person centred and detailed, giving support staff the appropriate information and guidance to support people with their needs and wishes.
Management oversight processes in place enabled the service to monitor the quality of care people received. Where issues were identified these were addressed immediately with further learning and development implemented to improve people’s experiences.
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 good (published 09 November 2017).
Why we inspected
We carried out an announced comprehensive inspection of this service on 19 October 2017. The service was rated good at that time. Due to the length of time since the last inspection, we undertook this focused inspection to check and confirm that the service continued to meet legal requirements.
We reviewed the key questions of safe, caring and well-led only to check and ensure people were receiving safe, good quality care.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
During this inspection we did not identify any areas of concern and found that the service had continued to meet legal requirements. Please see the safe, caring and well-led sections of this report for further detail.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
DHR Support Service Ltd is a domiciliary care service providing personal care and support to people living in their own homes. At the time of this inspection the service was providing care and support to three people with autism and learning disabilities. The provider’s future plans were to provide care and support within a supported living setting.
The service had a registered manager. 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.
One relative told us their relative received safe care and support. A safeguarding vulnerable adults policy was available and accessible by all staff which provided guidance on how to recognise and report abuse. Care staff confirmed that they had received training in safeguarding adults and demonstrated a clear understanding of the different types of abuse and the actions they would take to report any concerns.
Risk assessments in place identified people’s individual risks, the impact on the person and what was needed to reduce or mitigate the likelihood of the risk occurring. Risk assessments were discussed, reviewed and updated by the staff team on a monthly basis.
Care staff supported people with medicines where this was an identified need. For two people receiving support, medicine support was managed in partnership with involved family members. Records confirmed that medicines were managed safely and effectively and were administered by staff who had been trained and assessed as competent to do so.
Records gave assurance that safe recruitment systems were in place to ensure that only care staff suitable to work with vulnerable adults were employed.
Care staff told us and records confirmed that they had all received a comprehensive induction when they first began their employment with the company. Following this they had all received training in a variety of topics as part of an on-going training programme.
Care staff confirmed that they were supported positively through regular supervision and team meetings. Care staff were yet to receive an annual appraisal as they had not completed a full year of employment.
The registered manager and care staff demonstrated a good level of understanding of the Mental Capacity Act 2005 (MCA) and the importance of ensuring people have maximum choice and control of their lives and that they are supported in the least restrictive way possible. Staff also understood the importance of always obtaining people’s consent when supporting them with their care and support. However, although one relative confirmed that they had consented to the care and support that their relative received, care plans had not been signed to confirm that people or their relatives had consented to the care and support that they received.
Care plans were person centred, detailed and reflected the care and support needs of the person. Care plans were reviewed with the involvement of the person, relatives and the staff team on a regular basis and were updated accordingly.
People were supported with their healthcare needs where this support was an assessed need. We saw records detailing visits made to a variety of health care professionals, the reason for the visits, the outcome of the visits and any actions that needed to be taken post visit.
All staff knew the people they cared for and were very clear about the level of support each person required but also ensuring that each person maintained their own independence as far as practicably possible.
The provider had not received any complaints since they had begun providing a service. A complaints policy was available and accessible in an easy read format so that people and relatives were provided with guidance on how to raise a complaint. One relative told us that they did not have any complaints but knew who to speak with if they had any issues or concerns to raise.
The provider had a number of systems and processes in place to monitor and check the quality of care that was delivered. Where concerns were identified these were addressed so that subsequent learning could take place and improvements made to the delivery of service.