Archived: Affinity Trust - Domicilliary Care Agency - Southend and Essex

Affinity Trust – Domiciliary Care Agency – Southend and Essex is registered to provide personal care for adults with physical disabilities, learning disabilities and/or autistic spectrum conditions who live in shared or self-contained accommodation. At the time of our inspection care was being provided to 37 people.

A manager had been appointed on 4 April 2016 and was in the process of becoming registered with the Care Quality Commission. 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. The manager was supported by a team of support managers to ensure the daily management of the service.

The registered provider’s quality assurance systems and processes were not always robust and had not identified the issues we had acknowledged during our inspection. The arrangements for the administration and management of medicines had not been appropriately managed to ensure people’s safety and well-being. The manager provided an action plan as part of our inspection which they confirmed had been implemented immediately to improve practice in this area.

Although staff had received training on a range of subjects they had not received sufficient specialised training to effectively meet the individual needs of people using the service.

People told us they felt safe. The registered provider had effective recruitment procedures in place to protect people from the risk of avoidable harm. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. The manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS).

Care plans were person centred and included people’s preferences and individual needs. Care plans were regularly reviewed. People told us they were happy with the care and support they received; they were treated with dignity and respect and care was provided in a kind and caring way. People’s nutritional needs were met and people were supported to maintain a healthy and balanced diet. Where required people were supported to access health and social care professionals and services.

The registered provider had a formal process for handling complaints and concerns. They sought feedback from people who used the service and staff and analysed this information to help improve the quality of the service.

The summary is based on our observations during the inspection, from speaking with six people who were using the service and six staff who supported them. We also reviewed records relating to the management of the service and to the support needs of people who were using the service. These included, five support plans, daily support records and five staff files.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were clear and staff understood how to safeguard people they supported.

People told us that they felt their rights and dignity were respected.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and were fully involved in decisions about their care and lives.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected. Staff we spoke with said they had been properly recruited and trained.

Staff told us that they received good line management support in their roles which helped them to provide a caring and responsive service.

Is the service effective?

There was an advocacy service available if people requested it, this meant that when required people could access additional support.

People's health and care needs were assessed and they were involved in their plans of care.

People thought that their care plans were up to date and reflected their needs. Our review of records found this to be the case.

Is the service caring?

We spoke with people being supported by the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example, 'The staff help me in my home and take me out for shopping.' 'The staff from Affinity are good and ask me if I'm ok.' 'The manager visited me last week and asked me if I was alright, I know about my care plan, I look at this with staff and we decide what's in it'.

People using the service completed an annual satisfaction survey. If shortfalls or concerns were raised these would be taken on board and dealt with.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. One person using the service told us, "If I'm worried about anything I talk to the staff and they try to sort it out for me." Another person said, "I know I can complain if I want to, I have some guidelines at my home to tell me how to make a complaint but I have not needed to complain." A person using the service told us that they once made a complaint. They said that action was taken by the provider to their full satisfaction. We found that people could be assured complaints would be investigated and action taken as necessary.

The service worked well with other agencies and services to try to make sure people received care in a coherent way.

Is the service well-led?

The service had a quality assurance system. Records showed that identified problems and opportunities to change things for the better had been taken note of and addressed. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the aims and ideals of the service. This helped to ensure that people received a good quality service at all times.

We saw that the provider had a system in place to obtain and record people's consent. People's care records contained a support plan which showed which decisions people required support making. This showed that the provider gained consent where people were able to give this and complied with legal requirements where a person did not have capacity to make a decision.

People we spoke with were positive about the service they received. Comments included, "They are doing a good job," and, "They do their job very well."

People told us that staff usually arrived on time and one person told us that they would be informed if staff were late. Staff told us that the amount of work they were required to complete was reasonable. This suggested that staffing levels were sufficient for the numbers of people who used the service.

We saw that although there were some systems in place to assess the quality of service provision this required further development in order to be fully effective.

We found that the provider had a complaints procedure in place and saw evidence that this was followed. People we spoke with were aware of how to make a complaint.

We found that staff had been well trained and saw that they had a good understanding of people's individual needs. People were supported to enjoy good levels of activity and occupation to get out and about in the local community. People using the service and their families told us that they were very happy with the level of support provided.

People told us that they felt safe and secure with their care workers. People's relatives told us that they had no concerns about how people were treated.

People told us that they were happy with the quality of the service provided. We found that the provider consulted with people and monitored the service to ensure that standards would be maintained.