Doncaster Community Support

About the service

Doncaster Community Support is situated in the Kirk Sandall area of Doncaster. It provides care and support through a domiciliary care service and supported living service to people who live in their own homes. The service provides support to people living with a learning disability or autism spectrum disorder and older people. At the time of our inspection there were 107 people receiving a service from this provider.

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

Right Support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We have made a recommendation about staffing; people received the care and support they needed to be safe, however, there were not always enough staff on duty for people to access community leave and appointments. People had a choice about their living environment and were able to personalise their rooms.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture:

The provider did not have an effective governance system in place to identify issues we found on inspection. However, the registered manager and service managers were working hard to improve the culture and embed an ethos of learning and development within parts of the service. We have made a recommendation about supervision as staff in all areas of the service did not always receive regular 1-1 supervision. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality of life of their choosing. People and those important to them were involved in planning their care.

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 5 December 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to the Mental Capacity Act 2005 and good governance. We have made recommendations the provider ensures there are enough staff on duty, so people have access to the community and medical appointments and all staff within the service receive 1-1 supervision.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The inspection took place on 11 and 12 October 2017 and was announced. Our last scheduled inspection at this service took place in 25 August 2015 when we rated the service as Good overall, with an Outstanding rating in Caring.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Mencap Community Support’ on our website at www.cqc.org.uk’

The Doncaster branch of the Royal Mencap Society is situated in the Kirk Sandall area of Doncaster. It provides personal care to people living in the community. Personal care is provided to people accommodated in supported living environments and to people living in their own homes in the Doncaster area. Support packages are flexible and based on individual need.

The service had a registered manager in post at the time of our inspection. 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.

At this inspection we found the service had sustained the quality of service delivery and remained Good, with an Outstanding rating in Caring.

People who used the service experienced some very positive outcomes as a result of the caring and creative approach of staff and gave us positive feedback about their care and support. It was clear that the people who used the service had developed good and strong relationships with staff. People told us that staff had a caring approach, and praised the way staff upheld their dignity and treated them with respect.

The service actively involved people in planning their support, which enabled them to make choices about the support they needed to help them be as independent as possible. People were involved in updating their support plans regularly and they were written in a format that was suitable for people to understand.

The service worked in partnership with other organisations, such as healthcare services, to make sure people received the care and support they needed. The service managed risks to people well and people were supported to take their medicines safely.

Equality, diversity and human rights were at the forefront of how support was provided. The registered manager and members of the team were committed to a strong person centred culture. The key principles on which the service was built, was a vision of a world where people with a learning disability are valued equally, listened to and included. These values were reflected in the day-to-day practice of staff.

Staff were recruited safely and trained to a particularly good standard. They received service specific training which enabled them to meet people’s needs and promote their independence. Staff were able to undertake nationally recognised training to help them progress in their work and were encouraged to progress into more senior roles within the organisation.

Staff knew how to recognise and respond to abuse. Staff told us they could raise any concerns with the registered manager and felt that they were listened to. They attended regular team meetings and staff events. Formal supervision and quality monitoring of their work performance meant staff worked to the values and expectations of the service.

Staff demonstrated a good awareness of the principles of the Mental Capacity Act 2005 and put people who used the service at the centre of everything they wanted to achieve. Staff made sure people gave informed consent to their care and support, or that appropriate procedures were followed where people might lack the mental capacity to give consent.

People were actively encouraged to give their views and raise concerns or complaints. There was a clear, unambiguous complaints policy and procedure that was accessible to everyone. The feedback and complaints management system was seen as an integral part of continuous improvement.

There were effective processes in place to monitor quality and understand the experiences of people who used the service. Where improvements were needed, these were addressed. People’s views were continuously sought. This helped to shape the service for the future. There was strong emphasis on continual improvement and best practice, which benefited people who used the service and staff. Feedback from people, whether positive or negative, and was used as an opportunity to improve the service.

Before people received care and treatment they were asked for their consent and the

provider acted in accordance with their wishes. The appropriate procedure was followed where people were not able to give consent.

People who used the service had a support plan which was person centred and relevant to their individual needs. One person who used the service said, "I am involved in my life and staff respect my choices.'

People were supported to be able to eat and drink sufficient amounts to meet their needs. People we spoke with said they select the foods they wish to eat. One person said, "We try healthy food but we have a take away on occasions.' Another person said, 'We have a menu but if we want something different it's fine.'

The staff we spoke with were knowledgeable about infect ion control. People who used the service supported to keep their accommodation clean.

We found that the provider had an effective recruitment procedure in place. Appropriate checks were undertaken before staff began work.

There was an effective complaints procedure in place and people knew how to complain if needed. People we spoke with said they never had to complain, but they felt staff would listen to them and act on any concern they had.