About the service Arch Domiciliary Care Services provides care at home and is a supported living service. People live in the community in single accommodation or with family. There are 12 supported living settings and staff provide onsite 24-hour care in the some of these supported living sites, and some people receive 24- hour care in the community. People receiving support are living with a learning disability, and or autism, mental health needs and some people have physical needs and complex health conditions. The service provides care and support for children, young people and adults.
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. At the time of the inspection, 98 people were receiving the regulated activity of personal care.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: People received care and support that enabled them to have choice and control of their care. People’s independence was promoted. 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.
Right Care: People received care and support that was personalised and provided by an individual staff team who were well trained and supported. People were enabled to achieve positive outcomes and led an active and fulfilling life.
Right Culture: There was a shared commitment to the culture and values of the service. Feedback received from people who used the service, relatives, staff and external professionals about the leadership and management were consistently highly positive. The registered manager understood their role and responsibilities. They showed great commitment, flexibility and a positive can-do attitude, ensuring people remained at the center of their care and support. There were effective systems and processes in place to continually review, monitor and improve quality and safety.
People were supported to manage known risks effectively and safely. There was a multi-disciplinary approach to risk management. People were supported to maintain their tenancy, including monitoring environmental health and safety.
Staff were safely recruited and provided consistently and continuity in care. Staff received ongoing training that included areas of care and support, individual to the person.
Staff understood how to recognise where people may be at risk of harm or abuse and knew what action to take. People received support to take medicines and systems were in place to ensure this was completed safely and effectively.
Staff had received training in the management and best practice guidance of infection prevention and control.
People and their relative and or advocate, were supported and invited to share their experience about the service. The staff worked well with external agencies and health and social care professionals, in supporting people with their ongoing care and support needs.
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 31 August 2019).
Why we inspected
We were aware physical intervention was sometimes used and we wanted to be assured that best practice guidance was followed, and people were being safely supported. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for this service has remained good based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arch Domiciliary Care Services on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.