Discovery Home

Discovery Home is a domiciliary care agency. The service provides personal care to children and younger disabled adults. At the time of our inspection the service was providing personal care to 32 people.

Not everyone who used the service received personal care. CQC only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.

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 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.

People were supported by staff to pursue their interests.

Staff supported people to make decisions following best practice in decision making. Staff communicated with people in ways that met their needs.

Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care:.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture:

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so.

Staff had training on how to recognise and report abuse and they knew how to apply it.

Staff could recognise signs when people experienced emotional distress and knew how to support them to minimise the need to restrict their freedom to keep them safe.

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 requires improvement (published 21 October 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Discovery Home is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to children and younger disabled 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 the provider was supporting 79 people in the London Boroughs of Tower Hamlets and Newham, however only 17 people were receiving personal care. The remaining people were supported with befriending and outreach support.

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

Although there were monitoring processes in place, there was not an effective system in place to ensure accurate records about the care and support people received were being completed or audited to ensure their needs were being met.

Minor improvements were needed to ensure safer recruitment processes were followed and evidence of satisfactory conduct in previous employment within the health and social care industry had been obtained.

Relatives were positive about the kind and compassionate attitude of the staff team. One relative said, “I am very happy and would definitely recommend them.”

Relatives told us how important it was that staff could communicate with them and their family members in their own language and understood their cultural requirements.

Relatives were reassured with the skills and experience of their regular care workers when managing complex health conditions and behaviours that challenged the service.

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.

Relatives spoke positively about the management of the service and felt any issues would be dealt with appropriately by the registered manager. Relatives told us they felt comfortable approaching the management team if they had any concerns.

People were supported by a staff team that felt motivated working for the provider and praised the support they received.

We have made two recommendations that the provider ensures guidelines for staff to follow to minimise assessed risks are updated in people’s care records and safer recruitment processes are followed.

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 5 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality. 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.

Discovery Home provides care and support for adults and children with complex needs in their own homes. The domiciliary care service operates from the provider’s eight bedded respite service for children which helps family carers take a break from caring responsibilities. At the time of this inspection the domiciliary care service was providing support to six adults and nine children.

The service did not have a registered manager in post. At the time of our inspection a candidate and been recruited to the registered managers position but had not yet started their role. 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.

Recruitment checks were carried out to assess the suitability of the staff employed by the service. There were enough staff available to meet people’s needs. Staff received an induction and regular training which ensured they had the required skills to meet people’s needs.

People were involved in planning their care and consented to their plans of care. Risks had been assessed, and reviewed when people’s needs had changed and action was taken to safeguard people from abuse. Continuity of care was available to people who used the service as they were given to the opportunity to access additional services offered by the provider.

The principles of the Mental Capacity Act 2005 (MCA) were followed. Staff had completed training and understood the MCA, and people’s consent was sought in line with legislation and guidance.

People’s health and nutritional needs were met and any concerns acted upon. People told us staff treated them in a caring and kind way and respected their dignity. Staff listened to people’s wishes and supported them to make choices about their care. People’s relatives told us they were supported by caring staff.

The provider considered people’s individual needs and made changes which ensured they received their care in a way they preferred. People told us they knew how to complain and the provider had a system in place to record and respond to complaints.

The provider promoted an inclusive culture. People felt the management were approachable and that they were supported. People were encouraged to share their experiences and these were acted on to improve the quality of care provided. Systems were in place to monitor the quality of the service provided to ensure the service was effectively delivering good quality care.

We were told that the family were involved in the person's care planning. We saw that the person's care needs were assessed and recorded in their care plan. Risk assessments had been carried out. Systems were in place to protect people from abuse and the relative of the person using the service said they felt safe.

We spoke with three members of staff, including the manager, about the training and support provided by Discovery Homes. They told us they received regular training, supervision and an annual appraisal.

As the agency was new the manager told us it was too soon to ask people and staff to give feedback about the quality of the service through a survey. However the relative we spoke with told us that the manager visited them every two weeks to check whether they were happy with the service provided.