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. We considered this guidance as there were people using the service who have a learning disability and/ or who are autistic.About the service
Emezzions is a domiciliary care service providing personal care. The service provides support to people living in their own homes and those in supported living services. At the time of our inspection there was 1 person in receipt of personal care, who was living in a supported living service run by the provider. The provider ran other supported living services, but people using those services were not in receipt of a regulated activity. The provider supported people with learning disabilities and mental health needs.
People’s experience of the service and what we found:
Right Care
The person felt safe. Staff were caring and treated them with dignity and respect. People’s care and risk management plans did not always set out their current care needs and lacked detail in their preferences and personalised information. Staff received regular training, supervision and the provider checked their competency. The person we spoke with felt the service was managed well and their care needs were met.
Right Support
The provider did not always operate safe recruitment processes. Although the provider supported the person with their meals when needed, there was little recorded information about their preferences in relation to food and there was no evidence the provider actively encouraged healthier food options for the person as was required. Staff communicated with the person effectively. The provider had appropriate infection prevention and control measures in place and staff supported the person with their medicines appropriately. There were appropriate procedures for responding to and learning from accidents and incidents. There were enough staff to meet the person's needs. The person was 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 Culture
The person we spoke with knew how to raise issues or complaints and the provider responded to these appropriately. There were systems in place to monitor the quality of the service and although the provider was using these, they did not identify the issues we found. The person and staff were asked to give feedback about the service. The service worked in partnership with other professionals to meet people’s needs, but their recommendations were not always fully incorporated into people’s plan of care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 9 October 2020 and this is the first inspection.
Why we inspected
The inspection was prompted in part by the notification of an incident, following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of people’s health conditions. This inspection examined those risks.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to person- centred care, safe care and treatment and good governance.
We have made a recommendation relating to working with other agencies.
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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.