- Homecare service
Look Ahead Domiciliary Care (Hertfordshire)
Assessment report published 16 June 2025
Contents
Ratings
Our view of the service
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.
People's experience of this service
We met 5 people who used the service and communicated with 4 people and 2 relatives about their experience of the care provided. Where people who used the service were unable to talk with us, we used different ways of communicating including using Makaton (a type of sign language), pictures, objects and their body language. We are improving how we hear people's experience and views on services, when they have limited verbal communication.
People and relatives gave mixed views about the experiences they had with Look Ahead Domiciliary Care (Hertfordshire). In some cases, it was evident that people felt safe in the support they received and were enabled to be as independent as possible, however not all people received consistently good experiences. People shared and we observed that they were not always supported to have control of their lives. There was evidence of an imbalance in relationships with staff and people where people were not always the centre of decisions being made.