Archived: The Durnford Society Domiciliary Care Service

The Durnford Society Domiciliary Care Service provides care and support to people living in a 'supported living' setting, 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.

The service supports some people on a 24 hour basis and others who may require support with personal care needs at specific times of the day and/or night. At the time of this inspection, 38 people received support with their personal care needs from the agency.

The service had a registered manager in post. 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 the last inspection in January 2016 the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

We visited and spoke to seven people in their own homes and observed the interaction between them and the staff supporting them. People were not all able to fully verbalise their views, so staff used other methods of communication, for example visual choices and sign language.

People remained safe using the service. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People had their needs met by suitable numbers of staff, with additional staff support arranged when needed. One relative said how safe and well looked after their relative was.

Peoples’ medicines were managed safely. Staff received medicines training and understood the importance of safe administration and management of medicines.

People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected.

Peoples’ risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to help support and enable people to retain as much independence as possible and help reduce risks from occurring. Risks associated with people's care and living environment were effectively managed to ensure their freedom was promoted. People were supported by consistent staff to help meet their needs. People's independence was encouraged and staff helped people feel valued by supporting people to engage in everyday tasks, for example cleaning and shopping.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff confirmed they attended team meetings and they received one to one supervision to monitor their practice with appraisals of performance. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity policy of the company.

People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. Staff monitored people's health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

People were enabled and supported to lead fulfilling, independent and active lives. 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 practice. People were supported to reach their goals and ambitions.

People’s equality and diversity was respected and people were supported in the way they wanted to be. People's human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA).

People continued to receive a service that was caring. Staff demonstrated kindness and compassion for people through their conversations and interactions. If people found it difficult to communicate or express themselves, staff offered additional support and showed patience and understanding.

The service was responsive to people's needs and people were able to make choices about their day to day routines. People had access to a range of organised and informal activities which provided them with mental and social stimulation. People were supported to access the local community including part time employment.

People could make a complaint and were confident action would be taken to address their concerns. The registered manager and provider treated complaints as an opportunity to learn and improve. The complaints procedure was available in an easy read version to assist people.

People’s communication needs were known by staff. Staff adapted their communication methods dependent upon people’s needs, for example using simple questions and easy to understand information for people with cognitive difficulties. The service remained responsive to people's individual needs and provided personalised care and support. The registered manager had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need. People received information in a format suitable for their individual needs. Throughout the inspection we saw evidence of how the registered manager and staff understood and promoted people's rights as equals regardless of their disabilities, backgrounds or beliefs.

The service was well led. The provider had systems in place to monitor, assess and improve the service. There was an open culture, and people, relatives and staff said they found access to the office and management team welcoming and easy. Staff were positive and happy in their jobs. There was a clear organisational structure in place.

Durnford Society DCA provides care and support to adults of all ages, in their own homes. The Durnford Society DCA is owned by Durnford Society Limited. Durnford Society Limited runs a number of services within the Plymouth area. On the day of the inspection 38 people were being supported by the DCA with their personal care needs.

The service had a registered manager in post. 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.

People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. Staff had completed training and had the right skills and knowledge to meet people’s needs. There were sufficient numbers of staff employed to support people safely. Staff completed an induction programme. Staff described the management as open, supportive and approachable. Staff talked positively about their jobs and felt motivated to provide quality care.

People’s care records contained information that described what staff needed to do to provide personalised care and support. Staff responded well to people’s change in needs. Where appropriate, friends, relatives and health and social care professionals were involved in identifying people’s needs. People’s preferences, life histories, disabilities and abilities were taken into account, communicated and recorded.

People’s risks were monitored and well managed. The service had policies and procedures in place and these were understood by staff to help protect people and keep them safe.

People were encouraged and supported to maintain a healthy balanced diet.

People’s medicines were managed safely and people and staff told us the medicines were received as prescribed.

People, their relatives and staff were encouraged to be involved and help drive continuous improvements. This helped ensure positive progress was made in the delivery of care and support provided by the service.

The registered manager sought verbal feedback from people and encouraged people to share their concerns and complaints. The registered manager investigated any complaints or concerns thoroughly and used the outcome as an opportunity for learning to take place.

The registered manager had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.

There were effective quality assurance systems in place to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.

The registered manager and staff had completed training in the Mental Capacity Act. The registered manager displayed a good understanding of the requirements of the act, which had been followed in practice.

People were kept safe and protected from discrimination. All staff had undertaken training on safeguarding from abuse and equality and diversity. Staff understood the principles, had a good knowledge on how to report any concerns and described what action they would take to protect people against harm.

At the time of our visit, Durnford Society provided care to thirty-eight people in their own homes. We visited eight people and observed that staff were familiar with people needs and were able to communicate with them, even where people were unable to communicate verbally. People told us that they liked the staff who worked with them and that the staff supported them to undertake a range of activities and hobbies.

We reviewed records which showed that people's needs and risks were assessed and care plans were developed to support them. We reviewed records which showed that staff provided the support that had been identified in the care plan.

We found that if staff had a safeguarding issue they reported it to managers who would work with the local safeguarding team to address the concern. Staff had had safeguarding training and were able to describe what to do if they had a concern.

Staff worked in teams and knew the people they worked with well. Staff were supported to undertake additional qualifications and other training. New staff received an induction and initially worked with other staff.

The provider had systems to monitor and assess the care including audits, surveys and inspections.