Background to this inspection
Updated
28 April 2022
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was conducted by two adult social care inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in 11 ‘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.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because the supported living settings are small and people are often out and we wanted to be sure there would be people at home to speak with us and for people to consent to speaking with us.
Inspection activity started on 22 February 2022 and ended on 01 March 2022. We visited the location’s office on 22 February 2022 and 23 February 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 11 people who used the service and eight relatives about their experience of the care provided. We also observed interactions between staff and 12 other people who used the service. We spoke with 14 members of staff including the registered manager, home managers, senior care workers and care workers.
We reviewed a range of records. This included 11 people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We completed observations at a number of the locations of the service to ensure we had a full picture of how staff worked well with people.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with one social care professional that had knowledge of the service.
Updated
28 April 2022
About the service
Cavendish Domiciliary Care Agency is a supported living service providing personal care to 44 people aged 18 and over at the time of the inspection. The people receiving support were all living with learning disabilities.
The service supports people over eleven locations of houses of multi-occupation, these are maintained by landlords and are in the Surrey area. 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 40 people were receiving personal care.
People’s experience of using this service and what we found
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.
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.
Right support: People had maximum choice in their life and staff encouraged people’s independence whenever possible. People made decisions about their care and activities they wanted to partake in. People chose how they received their care and how staff supported them. This led to people having a fulfilling and meaningful everyday life.
Right care: People received a high level of person-centred care and were supported by kind and caring staff. Staff applied a person-centred approach in every element of people’s care. People’s privacy and dignity were promoted by passionate staff.
Right culture: The culture of the service, management and staff ensured inclusion of all people being supported. People were empowered to live confident lives being led by their choices and decisions. People and relatives were confident to raise concerns or suggested changes for the service as a whole as well as to their personal care. The provider ensured risks of a closed culture were minimised and people received support based on transparency, respect and inclusivity.
The service prioritised people completely and this was obvious through feedback we received. People were supported to follow hobbies and interests, and staff ensured a person-centred approach to people’s preferences. People lived in homely environments and their quality of life had improved since being supported by Cavendish.
Staff were passionate about providing the best care possible and included people to make all decisions about their care with a person-centred approach. Staff were also passionate about people achieving their goals and dreams and worked hard to ensure they supported people in this area. People told us staff would do everything possible to ensure they could live their best lives possible and achieve their dreams.
People were treated with the utmost respect by caring and kind staff. Staff had received specialist training to support people with an individual approach. This included input from a behavioural specialist that tailored training to ensure all people’s individual, specialist needs were met.
People were encouraged to be as independent as possible. Staff showed us examples of how people had become dramatically more independent since moving to one of the locations. Examples of this were seen during observations and people spoke to us with pride when detailing their independence.
There was a clear management structure within the service which meant the registered manager and all staff were confident with the roles they were in. This resulted in people receiving an excellent level of care due to the oversight staff had of the service as a whole.
People were kept safe from risk of harm and the registered manager followed safe recruitment processes.
People were supported to access healthcare specialists in a timely way and staff also worked well with social care professionals, when appropriate.
Rating at last inspection
The last rating for the service under the previous provider was good (published 18 July 2017). The provider changed in May 2019 and the service has not been inspected under the new provider.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.