The Care Quality Commission
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Archived: Didcot Self Directed Support Service

Overall: Requires improvement read more about inspection ratings

95a Wantage Road, Didcot, Oxfordshire, OX11 0AF (01235) 818236

Provided and run by:
Advance Housing and Support Ltd

All Inspections

25 November 2015

During an inspection looking at part of the service

We inspected this service on 25 November 2015. This was an announced focused inspection.

At a comprehensive inspection of this service in August 2015, we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued the provider with a warning notice. The warning notice required the provider to meet the legal requirements of the regulation by 31 October 2015. After the comprehensive inspection the provider wrote to us to say what they would do to meet the legal requirements in relation to the breaches of the regulations.

We undertook this focused inspection to check the provider had followed their action plans and to confirm they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Didcot Self Directed Support Service on our website at www.cqc.org.uk.

The service did not have a registered manager; however, there was a new manager in post and an application for registration was with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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's care plans contained up to date information and were regularly reviewed, this included risk assessments and risk management plans. However, there were still improvements needed to ensure risk management was accurately recorded.

People had correct and up to date information in their homes so staff could support them safely. They had been provided with contact numbers to assist them in an emergency.

The provider had taken action to ensure staff had the knowledge and skills to deliver care and support safely. Staff were meeting with management regularly to ensure they had the support needed to deliver effective care.

The providers had introduced effective systems to monitor the service and had an overview of all accidents and incidents.

Since August 2015, the provider had improved the system for managing the service. However, we have not changed the overall rating for this service because we want to be sure that the improvements will be sustained and embedded in practice. We will check this during our next planned comprehensive inspection.

10 August 2015

During a routine inspection

We inspected Didcot Self Directed Support Service on 10 August 2015. We gave the service 48 hours’ notice that we would be visiting. The service is a domiciliary care agency providing care and support to 23 people who live in the community.

The service did not have a registered manager; however, an application was with the Care Quality Commission (CQC) to register a manager for the service. A registered manager is a person who has registered with the 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 told us they felt safe. However, some risks associated with people's support needs were not always documented. Not all risk assessments had been updated. People were not always informed of changes of staff or cancelled visits.

Staff did not always receive regular support. Some staff training was incomplete or out of date. Some staff had not received regular supervision with their line manager, though most staff had undergone an appraisal in the past year.

There were systems in place to monitor the quality and safety of the service but they were not used consistently or always effective in driving improvement of the service.

The service was not always following the principles of the Mental Capacity Act (MCA) 2005. The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. People said they were given choices during their support.

People were involved in their care planning with their support workers. Assessments were made of people's needs to create support plans, but not all support plans were up to date. The support plans were not clear about when people received support or what support was specifically required. We were unable to inspect daily records of people’s care as they were not held in the office. A staff member told us that records were not inspected regularly in the people’s homes.

The service was not well led. There had been inconsistent management since our last inspection and staff were not being clearly communicated with. Although checks to see actions needed had been carried out, the systems used to monitor the quality of service were not effective and had not identified the changes necessary to ensure people’s safety.

We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the CQC (Registration) Regulations 2009.

9 April 2013

During an inspection looking at part of the service

We found that people were asked for their consent before receiving care and treatment. One person we spoke with told us 'if I am unwell they always ask me if I want the doctor to be called '. We saw documents confirming how consent was sought signed by people involved.

We found people had good care plans in place which enabled staff to support them in the way they wanted to be supported. One person we spoke with told us 'the carers know their job and they know what I want and how I want it'.

People were supported by skilled and experienced staff. One member of staff told us 'there has been improvements since you last visited, the new internal manger has looked at training and requested the training I have been wanting'. One person we spoke with told us 'that staff are all very good'.

We found the service had introduced quality assurance methods which involved people, to make sure they maintained and enhanced the quality of the service they were providing. One person told us 'I tell my carers if I don't like anything, I can talk to them '.

We found improvements in record keeping and care records. We found that record were kept securely. One staff member informed us "there has been a change in the records for everyone, they are much better now and more up to date, even our own personal files have been improved".

16 January 2013

During a routine inspection

We found the service was supporting one person. We saw a care plan and assessment that reflected the person's needs and choices. The person told us 'they told me about the care, I agreed'.

We found that the person was happy with the care provided and told us "they are very good, I know when they are coming each day and I see the same staff'.

We found the service knew how to protect people from all forms of abuse. The person using the service told us 'I feel safe, if I am unhappy I tell the carer'.

Staff were supported and trained to deliver good care. One staff member told us 'training is very good; I have completed my basic training and can request any extra training'.

We found inconsistencies in record keeping. We could not locate safeguarding training records. Care plans which were being updated were not available and some supervision records had not been recorded.