The Care Quality Commission
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Archived: East Anglia Domiciliary Care Branch

Overall: Inadequate read more about inspection ratings

Regus 1st Floor reception. Cavell House, Standard Place. St Crispens, Norwich, NR3 1YE (01603) 568266

Provided and run by:
Ambient Support Limited

Important: This service was previously registered at a different address - see old profile

All Inspections

During an assessment under our new approach

East Anglia Domiciliary Care Branch provides care and support to people, with a learning disability, living in a supported living setting, so they can live as independently as possible. People’s care and housing were provided under separate contractual agreements, the accommodation was provided by a separate landlord. CQC does not regulate premises used for supported living. We carried out our assessment between 14 November 2024 and 3 April 2025, when feedback was given. The assessment was carried out following our assessment in May 2024, when a warning notice was issued and in response to concerns about the risks within the service.

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with alearning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.’ We found the provider had failed to meet the principles of this.

The governance systems had failed to identify and rectify the widespread and significant concerns found at this assessment. People were not receiving consistently person-centred care to meet their needs in the least restrictive way. This was because there was not enough suitability trained and skilled staff to provide continuity of care. The risks and restrictions to people had not been consistently identified and/or mitigated. Legal consent to care was not always in place, including making decisions in their best interests. There was no effective system in place to manage concerns and complaints, poor incident management including systems for reviewing and learning to improve behaviour support for people.

The provider was previously in breach of the legal regulation in relation to safe care and treatment, person-centred care, dignity and respect, safeguarding service users from abuse and improper treatment, the need for consent, staffing and good governance. Improvements were not found at this assessment and the provider remained in breach of these regulations. We also found the provider was in breach of legal regulations relating to staff recruitment and meeting nutritional needs at this assessment.

In instances where CQC has decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been concluded.

This service remains in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

During an assessment under our new approach

East Anglia Domiciliary Care Branch is a domiciliary care service, who provide care and support to people living with a learning disability in their own homes in Norfolk and Suffolk. We carried out this as assessment in response to concerns we had about risks within the service. At the time of our assessment 48 people were using the service. We completed the assessment between 19 March 2024 and 17 May 2024 when feedback was given.

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’ (RSRCRC) 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. This guidance was reviewed as part of this assessment, and we found the provider had failed to meet the principles of it. People were not supported to live independent lives. Risks were not well managed. The provider did not have appropriate systems in place to ensure people were protected from the risk of abuse. There were not always sufficient levels of staff deployed to ensure safety of care. Staff were not sufficiently trained to meet the needs of people. People were not always given choices around their care. There was a lack of management and provider oversight to review shortfalls of care to make improvements. The provider did not focus on people’s quality of life and care delivery was not person-centred. The provider and staff did not recognise how to promote people’s rights, choices and independence.

There were 7 breaches identified in safe care and treatment, person-centred care, dignity and respect, safeguarding service users from abuse and improper treatment, the need for consent, staffing and good governance.

26 February 2019

During a routine inspection

About the service: East Anglia Domiciliary Care Branch is a domiciliary care service. They provide personal care and support to people with a learning disability living in their own homes in the Norfolk and Suffolk area. At the time of our inspection 78 people were using the service and it employed 174 care staff.

People’s experience of using this service:

¿The management team had a good oversight of the quality of the service provided. We have recommended that the provider review its formal quality monitoring systems to ensure these are fit for purpose and provide robust support to the management team.

¿People received safe care and support provided by caring and consistent staff who knew them well.

¿Careful recruitment meant the staff group had shared positive values and were committed to providing good quality care.

¿People were supported to be healthy, this included where people received support with food and drink.

¿People were involved in the assessing and planning of their care; their consent was sought and people felt in control.

¿People received individual care that met their specific needs and preferences.

¿The service was well led, people and staff were engaged and involved in the running of the service.

Rating at last inspection: At our last inspection, the service was rated "good". Our last report was published on 28 July 2016.

Why we inspected: We inspected this service in line with our inspection schedule for services currently rated as Good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any information is received that we need to follow up we may inspect sooner.

30 March 2016

During a routine inspection

East Anglian Domiciliary Care Agency is part of Heritage Care. The service provides support to people living in their own homes.

A registered manager was in post. 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.

The inspection was carried out on 30 and 31 March 2016.

The safety of people who used the service was promoted and enhanced by staff who had received training in safeguarding procedures. Staff had been recruited safely to ensure that they were appropriate to work with vulnerable people.

The service ensured that sufficient numbers of suitable staff were deployed to keep people safe and meet their needs.

Staff received appropriate and ongoing training to ensure that they had the skills and knowledge to meet people’s needs. Staff were well matched to meet people’s needs and had developed caring and positive relationships with them.

People received their medicines safely and as prescribed. The service maintained a good overview of the medicines records to identify any errors or omissions that might indicate additional training needs.

Risks to people’s wellbeing were identified and care plans devised to minimise their impact without unnecessarily restricting their freedom.

The service had a good understanding of the Mental Capacity Act (MCA) where it was appropriate within this service. People were enabled to express their wishes and preferences for how their support was delivered.

People were supported to have enough to eat and drink and maintain a healthy diet.

Care plans were comprehensively compiled, personalised and regularly reviewed to ensure that they reflected the current needs of people who used the service.

People were supported to express their views and were involved in decisions about how their care was delivered. People were treated with dignity and respect and their independence was promoted by the service.

The service responded appropriately to concerns and complaints and people were supported to express their views about the service.

The registered manager ensured the quality of service by carrying out regular audits where people were supported by the service.

The registered manager ensured their visibility in the service by talking to people when they carried out quality checks and by organising and attending inclusive social events for people who used the service.

2, 10 June 2014

During a routine inspection

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with four people who used the service, the registered manager and three members of staff. We also reviewed records relating to the management of the home which included, four care plans, daily care records, training records and support/supervision records of staff.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

We spoke with four people who used the service. They told us that their care and support was good and that they were safe.

We looked at four sets of care records which included risk assessments. Measures had been put in place to minimise any risks to people who used the service that ensured they were supported safely. For example, the risks to people's health through malnutrition, risks when outside the service they lived in and the risk of overspending had all been assessed and the care records we looked at showed how those risks had been minimised.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications had needed to be submitted, policies and procedures were in place and under review. Relevant staff had been trained to understand when an application might be necessary and how to submit one.

We discussed staffing rotas which showed that there were sufficient numbers of trained and competent members of staff employed to provide people with safe and appropriate care as planned.

Is the service effective?

People who used the service were treated with dignity and respect. We observed staff who were providing support to people. They spoke appropriately to people who used the service and were aware of people with communication difficulties and the best ways of communicating with them. For example, by using sign language or pictures when explaining things or offering choice.

People who used the service were supported in making choices. For example, what to wear or what main meal they preferred. Where people found it difficult to make choices for themselves, staff supported them in making decisions based on best interest principles.

Quality assurance measures were in place to identify the effectiveness of the service. This included questionnaires given to people who used the service, relatives, staff and visiting professionals. We saw audits of infection control measures, care and staff records, medication records, and the premises and environment. We saw that easy read documentation was used for people with difficulties in reading or understanding written documents. For example, their complaints procedure was in all the care plans in an easy read format.

Is the service caring?

We saw that people were cared for in an appropriate manner. Staff were attentive to their needs and familiar with people's likes and dislikes. Records we looked at showed that people's needs had been assessed and details of likes, dislikes, routines and preferences were recorded.

The care records were based on person centred principles and individualised to meet the needs of the person in understanding and being involved in their care plan.

Is the service responsive?

The records we looked at showed that people's needs, choices and personal preferences had been assessed and planned for. Staff we observed during our inspection were familiar with each person and their individuality.

People's health and social care needs were attended to. People were supported to engage in a variety of vocational, social and recreational activities when they chose to do so. They were also supported to maintain contact with their friends and family members. A number of community based facilities were used to promote people's involvement in the community including day centres, the cinema, sports and recreational facilities.

Is the service well-led?

There were monitoring and reviewing systems in place to ensure that the quality of the care and support provided was high. Staff members told us that they had the training and support to safely do their job, which they said they enjoyed.

Members of staff and family members of people, who used the service, were provided with opportunities to make suggestions and comments to improve the quality of people's support and care. These were developed into an action plan which identified the improvements made and ensured that the service was able to confirm when required improvements were completed.

Staff we spoke with told us that they felt well supported and records showed that regular support and supervision was taking place.