Archived: Mencap - Norfolk Domiciliary Care Agency

Mencap - Norwich Domiciliary Care Agency provides services to people living in their own homes. At the time of the inspection, 19 people were receiving a regulated activity of ‘personal care.’

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People received person-centred, specialist care and support including at the end of their lives. Staff worked closely with healthcare professionals to ensure people’s pain levels were well managed, and they received dignified care. Staff demonstrated skills and receipt of specialist training in relation to the support provided to people with complex epilepsy.

Staff showed kindness and compassion and placed value on their caring role and involvement in people’s lives. People were offered a choice of meals and staff closely monitored people assessed to be at risk of poor food and fluid intake.

The service worked in partnership with people and their families and encouraged feedback on the care provided. Staff told us they enjoyed working for the service and spoke highly of the support and encouragement provided by the registered manager.

People had their care and support needs met by sufficient numbers of suitably trained staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and systems in the service supported this practice.

The service had good governance arrangements in place and completed internal quality checks and audits. Findings from these were regularly reviewed by the registered manager and provider.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Rating at last inspection The last rating for this service was Good, (report published 09 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 22 and 23 November and 13 December 2016 and was announced. Royal Mencap – Norwich Domiciliary Care Agency is registered to provide personal care to younger adults and people who have learning disabilities or autistic spectrum disorder who live in supported living schemes in the Norwich area. At the time of our inspection 18 people were receiving personal care from the service. The amount of support provided to people was based on their assessed needs and varied from 24 hours a day support for people with very complex support and care needs to a few hours each week for people who were relatively independent.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 scheme is run.

There were systems in place to help keep people safe from harm. Staff knew what abuse was and they were also aware of how to report any concerns about peoples’ safety if they had them. There were enough staff to meet people's needs with a regular, consistent staff team. There were robust recruitment practices in place, which meant staff had been recruited safely.

Medicines were managed in a safe way and support was offered by staff when needed. Risks to people and staff had been assessed. People felt safe and where risks to people were identified, action was taken to reduce them.

People were supported by well trained and skilled staff. Staff supervision, meetings and appraisals were taking place on a regular basis, which meant staff had the opportunity to reflect on and develop their practice.

People's rights to make their own decisions were promoted and respected. People confirmed they were involved in decision-making about their care and support needs where possible.

When needed, people were offered support to eat and drink and to participate in hobbies and pastimes they chose. Staff supported people to make and attend health appointments if requested.

People's care plans were comprehensive and provided guidance to staff on how to meet people's needs. People received support that was individualised to their specific needs.

Staff felt they were listened to and were given the opportunity to raise any concerns. Staff were knowledgeable about people's background histories, preferences and routines.

The management team assessed and monitored the quality of the service through audits that were undertaken.

We saw evidence that people were respected and involved in decisions about their support and personal care. A family member told us that their relative had become 'more independent' since the provider had taken over responsibility for their support. One person told us that they were a member of the 'events committee.' Another person told us 'the staff look after me very well.'

The provider's safeguarding policy detailed the procedures to be followed by staff if they suspected abuse had occurred. It was available in an 'easy to read' format. The provider also operated the 'Speak Out Safely' whistleblowing process. Staffing levels were sufficient to enable effective support and care to be given.

The provider obtained feedback from people who used the service in a number of ways, including surveys and meetings. The provider also carried out regular checks and audits. Complaints were investigated and actions taken in response. This showed us that the service was well-managed and responsive.