Background to this inspection
Updated
7 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one inspector.
Service and service type:
The service provides personal care for people with a learning disability, mental health issues and other conditions in their own home, some people chose to live together. People had their own bedrooms and shared communal spaces. The Care Quality Commission (CQC) regulates only the care provided, we do not regulate the premises where the person lives.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager had taken up post in November 2018 and registered with the Commission in February 2019.
Notice of inspection:
We gave the service 48 hours’ notice because we needed to be sure that people who wanted to speak with us were available. Inspection site activity started on 03 April 2019 and ended on 05 April 2019. We visited the office location on 03 and 05 April 2019 to see the registered manager; and to review care records and policies and procedures. On the 04 April we visited people in their homes.
What we did:
Before the inspection we reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as serious injuries. The provider had completed a Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. • Before the inspection we spoke to three relatives.
During the inspection we looked at the following:
We reviewed some records and made observations, these included;
• Five peoples care plans which included risk assessments and documents used to record day to day care.
• Four staff files and records in relation to training and supervision of staff.
• A variety of policies and procedures developed and implemented by the provider.
• Accidents and incident records.
• Records relating to the management of the service.
• We spoke with six people and spent time observing interactions between staff and people.
• We spoke with the registered manager, two other managers, the administrator and eight staff.
• After the inspection we spoke with one relative.
• After the inspection we received feedback form one healthcare professional.
After the inspection we received additional evidence from the provider which we took into consideration when making our judgments.
Updated
7 June 2019
About the service:
One Step South Domiciliary Care Agency provides care and support to people with a learning disability, mental health issues and other conditions living in their own homes. At the time of our inspection 21 people received the 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:
Overall the service met the characteristics of Requires Improvement.
¿ Communication between management and staff was not always sufficient, there had been some dissatisfaction within the staff team which had not been resolved quickly. Up until January 2019 managers oversaw different geographical areas.
¿ Records around managing people’s behaviour did not always reflect if behavioural guidance was being followed by staff. Support guidance did not always promote a positive behaviour approach.
¿ Staff spoke with people with kindness and respect, people were asked for permission before being supported with any care needs.
¿ There were enough staff to meet people’s needs, people were involved in recruiting new staff.
¿ Staff knew how to recognise abuse and protect people from the risk of abuse.
¿ Staff were trained in safe medicines management and people were involved in making decisions about how they took their medicines.
¿ Any incidents were recorded and analysed so additional measures could be implemented to minimise further incidents.
¿ People needs were continuously assessed.
¿ There was an ongoing programme of training and staff had regular supervision. Staff said they could contact a manager at any time for help and advice.
¿ The service was compliant with the Mental Capacity Act 2005.
¿ People were supported to eat and drink what they liked and when they wished. Staff advised people about healthy choices but respected their wishes if they chose unhealthy options.
¿ People were supported to look after their health as much as possible. People were supported to attend healthcare professional appointments.
¿ Each person had their own individual care plan which detailed the support they required. People were involved in their care plans.
¿ People had identified various goals to work towards.
¿ People were supported to raise any concerns.
¿ There was no one being supported with end of life care at the time of our inspection. People had been asked about their end of life wishes.
¿ The registered manager had a clear vision of the direction of the service and staff were positive about their appointment.
¿ The registered manager audited various aspects of the service including incidents and accidents and produced monthly reports.
¿ Feedback was sought from people, staff, relatives and professionals so the service could improve.
¿ The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; people were encouraged to be a part of the local community; attending clubs, day centres, leisure centres, local shops, pubs and other local services. People were supported to make their own decisions and be as independent as possible.
Rating at last inspection:
The provider had re-registered this service in April 2018, so this was the first rated inspection under their new registration.
Why we inspected:
This was a planned comprehensive inspection.
Enforcement: Action we told provider to take (refer to end of full report).
For more details, please see the full report which is on the CQC website at www.cqc.org.uk