Archived: Raynsford Domiciliary Care

At the time of the inspection the service provided support to 11 people who lived with a learning disability and/or autism. People referred to the service as 'Raynsford' so this has been reflected throughout this report. People lived in one building and shared the communal facilities. They had their own private accommodation in the building which they rented through a tenancy agreement.

There was a registered manager in place although not present at the inspection. 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.

We made one recommendation for improvement related to guidelines for the administration of some medicines.

'Raynsford' had a warm and welcoming atmosphere. People looked relaxed and told us they liked living there.

People were kept safe and supported to help keep themselves safe when using the community.

Risks to people were identified and people were involved in deciding how these risks would be managed.

People received support to take their medicines.

People’s support was provided by staff who had received training and support to be able to do this and who knew the people well.

People were supported to look after their health and to eat in a healthy way. They had access to appropriate health and social care professionals as needed.

People were supported to make their own decisions about their care and treatment. People’s care and support was provided to them with their consent.

People unable to make decisions independently or who could not provide consent had their care and support provided in a way which protected their best interests.

People told us the staff cared for them and were kind towards them. Staff listened to what people had to say and genuinely wanted to improve their quality of life.

People were treated with respect and given privacy when appropriate. Information about people was kept confidential and secure. People’s family members and friends were welcomed and also supported.

People were actively involved in planning their care and they had opportunities to review this and to make agreed alterations.

People were provided with support to go to work and take part in a full social life, if, this is what they wanted.

People’s right to independence was respected, encouraged and supported where needed.

There were arrangements in place for people to make a complaint and have what was making them unhappy sorted out.

The service was well led but improvements were needed to how the registered provider and registered manager achieved planned improvements to the service. They were aware of this and plans to achieve this were underway.

Feedback from people and their relatives had been sought and all comments reviewed were positive. Health care professional made positive comments about the service.

In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. We have advised the provider of what they need to do to remove the individual's name from our register.

Is the service safe?

The environment was clean and secure from anyone entering unannounced. Care records were held securely and were only accessed by authorised people.

There were sufficient numbers of staff available to support people in the service in the daily activities they chose to take part in. People who used the service told us they felt safe and confident to raise any safeguarding concerns to the manager.

The provider could demonstrate all recruitment and employment practices were followed and staff had the skills and experience required to support people who used the service. Staff personnel records contained all checks required to keep people in the service safe. Staff described to us how they would recognise safeguarding alerts and said they were confident to raise any concerns to the manager.

Is the service effective?

People can be reassured their needs will be met at this service. Each person had their own person centred plan that detailed their support needs. People told us they were happy with the staff support they received from the staff team.

There was a safe procedure for recruiting staff and for making sure they had the skills and knowledge to support people appropriately.

Staff had a good understanding of people's care and support needs, knew people in the service well and received good training.

Is the service caring?

We saw staff demonstrated a great deal of kindness and encouraged people to make their own decisions. There was a great deal of humour and good-natured conversations with people in the service.

We saw a survey provided to people in the service and their families was complimentary about the support people received.

Is the service responsive?

People's support needs were regularly reviewed with people and their keyworker. Support plans and risk assessments reflected people's individual needs and were updated promptly when necessary.

People in the service had regular access to their doctor or dentist when necessary.

People led busy lives, accessed activities that were important to them and were supported to maintain relationships with friends and relatives.

Is the service well-led?

Staff had a good understanding of the ethos of the service and there were robust quality assurance processes in place to monitor the quality of the service being provided. These included feedback by the use of monthly audits, complaints received and questionnaires issued. All findings were addressed in a timely way.

People's personal care records were accurate and complete. All risks had been assessed, and safeguards put in place where necessary. Staff regularly received individual supervision by senior staff.

Everyone we spoke with told us that they were happy living in their own flats and staff supported them to make choices about their daily living. The service assessed people's capacity to make day-to-day decisions and what type of decisions may need to be made in their 'best interest'. We saw that staff had a good understanding of people's needs and used this knowledge to enable people to make their own day-to-day decisions about their care wherever possible.

Care plans were personalised to each individual's needs and detailed how people wished staff to support them to meet those needs. Risk assessments had been completed where necessary and all care records were regularly reviewed. The service supported people to take part in a wide range of activities that were individualised to each person's needs and choices. On the day of our visit some people had gone out independently to the shops, others had gone to activities such as horse riding, bowling, acting classes and gardening.

Appropriate arrangements were in place in relation to the recording and storage of medicine. Staff were appropriately trained, supervised and appraised. The provider sought the views of people who used the service and used these comments to improve and develop the service.

Everyone we spoke with told us that they were happy living in their own flats and staff helped them to live independent and full lives. People were able to go out as they wished and could choose to spend time in their flats or in the communal lounge/dining area. We saw that the service supported people to take part in a wide range of activities that were individualised to each person's needs and choices. On the day of our visit some people had gone out independently to the shops, others had gone horse riding, bowling and dog walking. People using the service told us 'I love living here and I love my flat' and 'The staff are brilliant'.

Care plans were personalised to each individual's needs and detailed the wishes of the person and how they wanted to receive their support. Risk assessments had been completed where necessary and all care records were regularly reviewed. People were involved in writing their care plans and were able to decide whether they wanted to keep their care records in their flats or to be stored securely by the service.

There were enough qualified, skilled and experienced staff to meet people's needs. The provider sought the views of people who used the service and used these comments to improve and develop the service.