Archived: Domiciliary Care Agency Kent and Sussex

Domiciliary Care Agency Kent and Sussex is a service that provides personal care and support to adults living in 'supported living' settings, so that they can live as independently as possible. This supported living service meets the needs of people with a learning disability and autistic people, people with mental health needs, and people who have a physical disability. Not everybody using the service received the Regulated activity of personal care. At the time of this inspection there were twenty people receiving personal care at eight different homes. The service is run from an office in Rochester in Kent.

People’s experience of using this service and what we found

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. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Rights Support

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. For example, people were supported to go out to work and one person told us they loved going to work. Staff supported people to achieve their aspirations and goals. One person told us how they were supported to pursue their goal of being a DJ. Staff supported people to take part in activities, pursue their interests in their local area and to interact online with people who had shared interests. Staff enabled people to access specialist health and social care support in the community.

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. During inspection we observed staff to be kind and compassionate to people, taking a genuine interest in what they liked doing and the support they needed. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Information would be given in a format that people needed such as picture cards and easy read posters. An easy read poster with the inspector’s picture on was given prior to visiting peoples’ homes. People had help to access easy read information to help people understand about this inspection. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

Right Culture

People and those important to them, including advocates, were involved in planning their care. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. For example, one person was supported to go on holiday this year and they were able to pick what they wanted to do which best suited them. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. Staff we spoke to were able to tell us people’s needs and preferences in relation to their care, support and aspirations.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 05 July 2018)

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service provides personal care and support to adults living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. This supported living service meets the needs of people who have mental health needs, a learning disability or autistic spectrum disorder and people who have a physical disability. Not everybody using the service received the Regulated activity of personal care. At the time of this inspection there were ten people receiving personal care. The service is run from an office in Rochester in Kent.

A registered manager was employed at the service and they were present during the 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.

We observed safe care. Staff had received training about protecting people from abuse and showed a good understanding of what their roles and responsibilities were in preventing abuse. People told us they felt safe with staff. Information was shared with people who used the service in different formats such as pictures and one to one conversations about how to raise concerns and protect themselves from potential abuse and bullying.

Staff assessed and treated people as individuals so that they understood how they planned people’s care to maintain their safety, health and wellbeing and choices. Risks were assessed within the service, both to individual people and for the wider risk from the environment people lived in. Actions to minimise risks were recorded.

Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. Staff understood the steps they should take to minimise risks when they were identified. The provider’s health and safety policies and management plans were implemented by staff to protect people from harm.

Staff were trained about the safe management of people with behaviours that may harm themselves or others.

The registered manager involved people in planning their care by assessing their needs based on a person centred approach. We observed and people described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered. People could involve relatives or others who were important to them when they chose the care they wanted.

The person centred care plans developed to assist staff to meet people’s needs told people’s life story, recorded who the important relatives and friends were in people’s lives and explained what lifestyle choices people had made. Care planning told staff what people could do independently, what skills people wanted to develop and what staff needed to help people to do.

People were often asked if they were happy with the care they received. The provider offered an inclusive service. The culture of the service was underpinned by nationally recognised standards called REACH. (The eleven REACH standards set out what people should expect, as equal citizens, from their staff team or agency offering them support.) The service also had policies about Equality, Diversity and Human Rights. People, their relatives and health care professionals had the opportunity to share their views about the service either face-to-face, or by using formal feedback forms.

The registered manager had experience of managing supported living services. The registered manager spent time at each service. This meant that the registered manager had an in depth knowledge of how the service was running and got to know people and staff very well. The registered manager and the provider had demonstrated a desire to improve the quality of the service for people by listening to feedback, asking people their views and improving how the service was delivered.

The registered manager and staff followed the Mental Capacity Act 2005 (MCA). The provider understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). Staff received training about this.

Safe recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The provider recruited staff with relevant experience and the right attitude to work with people who had learning disabilities.

New staff and existing staff were given an induction and on-going training which included information specific to the people’s needs in the service. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs. Staff received supervision and attended meetings that assisted them in maintaining their skills and knowledge of social care.

Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink. Staff supported people to maintain a balanced diet and monitor their nutritional health.

There were policies and procedures in place for the safe administration of medicines. People had control over their medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health.

People and staff felt that the service was well led. They told us that the registered manager, understood people’s needs, was approachable and listened to their views. The provider and registered manager continued to develop business plans to improve the service.

The quality outcomes promoted in the providers policies and procedures were monitored by the management in the service. Audits undertaken were based on cause and effect learning analysis, to improve quality. Staff understood their roles in meeting the expected quality levels and staff were empowered to challenge poor practice.

Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and had access to personal protective equipment like disposable gloves and apron’s.

Working in community settings staff often had to work on their own, but they were provided with good support and an ‘Outside Office Hours’ number to call during evenings and at weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.