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Look Ahead Domiciliary Care (Hertfordshire)

Overall: Good read more about inspection ratings

Oak View, 64-66 Hydean Way, Stevenage, Hertfordshire, SG2 9XL (01438) 740096

Provided and run by:
Look Ahead Care and Support Limited

All Inspections

During an assessment under our new approach

We undertook an inspection of Look Ahead Domiciliary (Hertfordshire) on 26 February to 26 March 2026. At our last inspection, the service was rated as Requires Improvement (Published 16 June 2025). This inspection was announced.This inspection followed the previous inspection where we found breaches of regulations.

Look Ahead Domiciliary Care (Hertfordshire) is a supported living service providing personal care to people living in their own homes. The service provides support to people with a learning disability and autistic people. At the time of our inspection, there were 19 people using the service, 15 people received the regulated activity.

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 Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The service met this guidance.

We spoke with 13 staff members. This included support workers, managers and senior leaders. We got feedback from professionals that supported people living at the service.

At the last inspection, we found a breach in keeping people safe from harm and abuse and governance. We issued 2 warning notices which outlined actions to take to improve people’s care. This assessment was triggered to review the warning notices. We found at this assessment that both warning notices were met, and the provider was no longer in breach of regulation.

The service demonstrated a positive and proactive culture of safety, with openness, learning, and accountability clearly embedded in practice. Staff understood how to recognise, report and respond to incidents and safeguarding concerns, and timely action was taken to help keep people safe. Risk assessments were person centred and regularly reviewed to promote independence while managing risk, including physical and emotional wellbeing. Since the last inspection, leaders had reflected on restrictive practices and ensured these were reviewed, justified, and aligned with the Mental Capacity Act 2005 ‑and least restrictive principles.

People received care in safe, well managed‑ environments, supported by sufficient numbers of skilled and competent staff. Recruitment processes were robust, and staff received regular training, supervision and support tailored to the needs of people using the service. Medicines were largely managed safely, and any identified gaps in staff knowledge were addressed promptly through management action. Infection prevention and control required further improvement to ensure risks were assessed and managed consistently across all environments; however, staff demonstrated awareness of risks and took appropriate action when concerns arose.

The service was well led, with compassionate, approachable leaders who promoted openness, inclusion and a shared sense of purpose. Staff felt supported, valued, and confident to raise concerns, and feedback was used to inform improvement. Governance systems provided oversight through audits, checks and learning from incidents, although further work was needed to fully embed registration and governance arrangements across all services. The provider worked effectively with partners and the wider community and demonstrated‑ a strong commitment to continuous learning, collaboration and improving outcomes and quality of life for people supported.

During an assessment under our new approach

We undertook an inspection for Look Ahead Domiciliary Care (Hertfordshire) on 17 March 2025 and 24 March 2025. This inspection was prompted by a review of the information we held about the service and intelligence received which suggested there was potentially a risk to people receiving support.

Look Ahead Domiciliary Care (Hertfordshire) is a supported living service providing personal care to people living in their own homes. The service provides support to people with a Learning disability and autistic people. At the time of our inspection there were 14 people using the service, 8 people received the regulated activity.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The service did not meet this guidance.

People did not always receive support that was the least restrictive. People were not always supported by staff with the correct skills and training, which put people at risk of harm.

People were not always protected from safeguarding risks in a timely manner, where risks had been identified in some cases risk assessments did not identify how to support the person.

Governance systems did not always identify improvements needed. Where required improvements had been identified, lessons learnt were not shared widely. We found disparity in the quality of systems in different services. In some cases, we found individual services and people received different quality of care. Some people received care that was person centred, where other people did not.

Staff showed kindness when speaking about people and knew them well. Staff felt supported by the teams they worked in and the management team.

We found a breach in regulations 12, 13, and 17. The provider did not ensure people were supported in the least restrictive way, people did not always have the choice and control of the daily life. People were not always supported by appropriately skilled staff. The provider’s governance systems were not always robust to identify areas of improvement, they were unable to evidence how improvements were then embedded in the services.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor.

30 April 2019

During a routine inspection

About the service: Look Ahead Domiciliary Care (Hertfordshire) is a domiciliary care agency providing care and support to seven people with learning difficulties in a supported living setting.

People’s experience of using this service:

People were happy with the care agency and the staff who provided their care.

People were safe using the agency because staff knew what they were doing, they had been trained and the building they lived in was secure. There were enough staff, and the registered manager (who has since left the service) also visited people regularly. Key recruitment checks were obtained before new staff started work.

People told us they always received their medicines and that staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. Staff took action to reduce the risks of spreading infection. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People liked the staff that cared for them. People told us that staff were “nice”, and “lovely”. They went on to tell us that staff supported them to live as they wanted. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the agency’s aim to deliver high quality care, which helped people to continue to live in their own homes.

Systems to monitor how well the agency was operating were carried out well. Where concerns were identified, the registered manager followed this up to make sure action was taken to rectify the issue.

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.

Rating at last inspection: Good. (Previous report published 15 September 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as scheduled in our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

16 August 2016

During a routine inspection

The inspection took place on 16 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a flexible care service; we needed to be sure that someone would be available to assist us with our inspection and that we could access the information we needed.

Look Ahead Domiciliary Care (Hertfordshire) provides care and support for up to 10 people with learning disabilities to live independently. Look Ahead Domiciliary Care (Hertfordshire) provides the personal care and support element and an independent landlord owns the property. The service also supports two further people who live in a neighbouring town to live independently. On the day of this inspection eight people were in receipt of the support provided under the regulated activity.

We last inspected the service on 06 December 2013 and found the service was meeting the required standards at that time.

There had not been a registered manager at Look Ahead Domiciliary Care (Hertfordshire) since the previous registered manager left the organisation in February 2016. A new manager had been recruited and had been in post since April 2016. They had submitted their application to register with CQC and this was in process at the time of this inspection. 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 2008 and associated Regulations about how the service is run.

People had health care and support plans in place to help ensure that staff knew how they liked their needs to be met. Risks to people’s safety and welfare had been identified and care had been planned to enable people to live as safely and independently as possible. There were sufficient numbers of staff available to meet people’s care and support needs. People’s medicines were managed safely. There were clear arrangements in place in the event of emergencies.

The systems in place to recruit staff were robust to help ensure that the right people were recruited to provide people’s care and support. Staff received on-going training to help ensure that they kept up to date with good practice and refresh their skills and knowledge. Consent to care and treatment was understood by the staff team and people were supported in line with the legislation. Information was available in communal areas about advocacy services should people feel they needed additional support with decision making.

Support was provided to promote healthy eating and access to health care services. Staff were caring and promoted people’s independence as much as possible. People were supported to access a range of activities outside their homes. People’s relatives told us they would be comfortable to raise any concerns with the management team and confident that they would be acted upon.

The culture of the service was open and staff were motivated and clear about the manager and provider’s objectives. The provider had arrangements to receive feedback from people who used the service and to drive forward improvement including regular monitoring by representatives of the provider.

6 December 2013

During a routine inspection

When we inspected Look Ahead Domiciliary Care on 06 December 2013 we found that people were routinely asked for their consent about their every-day care and the staff acted in accordance with their wishes.

Staff members worked to personal care guidelines which emphasised people's right to control when, how and from whom they received care. One person told us, 'They always ask me if it's alright and I say 'yes'.

People's needs were assessed and their care was planned according to their individual needs. We found that care plans were centred on and specific to each person because they were actively involved in their assessment of need. One person said, 'We have a one-to-one meeting every few months and we talk about what I need.'

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place for supporting people with their medicines. Accurate records were maintained in relation to medicines.

People and staff members reported to us that there were always enough staff on duty to support people. The provider's staffing requirement was based on the number of hours of support that the service were contracted to provide for each person.

People were asked for their views about the way the service provided their care and their views were acted on. One person told us, 'We have customer meetings every two weeks and I go to them all.'

The provider operated an effective quality management system involving reviews by a senior member of the provider's regional management team.

9 November 2012

During a routine inspection

When we visited Look Ahead Domiciliary Care (Hertfordshire) on 9 November 2012 we found that people were involved in making decisions about the way their care was delivered. One person told us, "My needs have changed. I told the staff and [this resulted in] changes for the better to my support plan." We also found that people's community involvement was supported and that they took part in communal activities in the apartment block as well as in the community.

People experienced care and treatment according to their individual needs and that kept them safe from harm. One person told us, "I like it here. I get help with everything I need." We also found that the service used a proactive care planning system. This allowed support to be delivered according to a person's established needs as well as responding to needs throughout the day. One person said, "I don't have any worries about anything".

People using this service were safe from the risk of abuse because the staff understood the nature of abuse and knew how to respond to concerns. One person told us they felt really safe.

People living in this apartment block were supported by visiting staff who were motivated and properly trained for their role.

We found that the provider had an effective system to monitor the quality of the service and that people using the service were involved in this process through regular meetings and the opportunity to provide feedback.