ESPA Domiciliary Agency

ESPA Domiciliary Agency is a care agency providing personal care to younger adults living in their own homes. People accessing the service are living with learning disabilities, autism, and/or complex needs. At the time of the inspection the service was providing support to 19 people, four of who were receiving support with personal care in their own homes.

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 and their relatives told us they were happy with the care and support they received. Comments included, “I am happy" and "I am delighted with the support [people] receive."

Staff were clear on their responsibilities for safeguarding people and showed a good knowledge of the actions they needed to take to keep people safe. There was an open and transparent culture in relation to any accidents and incidents. These were used by the management team as learning opportunities to lessen risks.

Medicines were managed safely. Enough staff were working for the service to ensure people received safe and effective levels of care. Recruitment and selection procedures ensured suitable staff were employed.

There was a proactive approach to assessing, anticipating and managing risk which allowed people to be safe whilst also enhancing and developing their independence and essential life skills. Care plans were person centred.

Staff were supported by a committed management team and told us they were proud to work for the service. There was an open and transparent culture where people were supported to be involved in their care and voice their opinions. Relatives told us the service was well-managed.

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 support provided to people living in their own homes maximised their choice, control and independence. People were involved in all aspects of their care and future planning. Care provided was centred around the person and promoted people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of the management team and support staff ensured people lead confident, inclusive and empowered lives.

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 16 January 2018).

Why we inspected

We undertook this focused inspection to check whether the provider continued to meet the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This report only covers our findings in relation to the Key Questions safe and well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ESPA Domiciliary Agency on our website at www.cqc.org.uk.

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger adults, people with learning disabilities or autistic spectrum disorders and people with mental health conditions. At the time of our inspection 16 people were receiving personal care from the service.

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.

There was a registered manager in place. 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.

Risks to people were assessed and plans put in place to reduce the chances of them occurring. Policies and procedures were in place to promote infection control. People’s medicines were managed safely. Policies and procedures were in place to safeguard people from abuse. The provider and registered manager monitored staffing levels to ensure enough staff were deployed to support people safely. The provider’s recruitment processes minimised the risk of unsuitable staff being employed.

Relatives told us staff had the knowledge and skills needed to support people. Staff completed mandatory training in a number of areas, and this was refreshed to ensure staff worked to current best practice. Newly recruited staff were required to complete the provider’s induction programme before they could support people without supervision. Staff spoke positively about the training they received. Staff were supported with supervisions and appraisals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this. People were supported to maintain a healthy diet and access external professionals where needed.

People were happy and relaxed with the staff supporting them. Relatives spoke positively about staff at the service, and described the support they delivered as kind and caring. People were treated with dignity and respect. Staff were knowledgeable about people’s communication needs, and used this information to engage with people effectively. People were supported to maintain as much independence as possible and to maintain and enhance their independent living skills. People were supported to access advocacy services where needed.

People received personalised support that was responsive to their support needs and preferences. Where it was part of their support package people were supported to access activities they enjoyed. Policies and procedures were in place to investigate and respond to complaints. At the time of our inspection no one was receiving end of life care but policies and procedures were in place to arrange this if needed.

Staff spoke positively about the culture and values of the service. Staff felt supported by management and had regular opportunities to contribute to the running of the service. Relatives spoke positively about the leadership of the service. The registered manager, provider and team leaders carried out a number of quality assurance audits to monitor and improve standards at the service. People's views were regularly sought and acted on. Staff were given opportunities to share best practice and discuss outcomes for people supported. The provider worked in partnership with others. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.