The Wilf Ward Family Trust Domiciliary Care Scarborough

The Wilf Ward Family Trust Domiciliary Care Scarborough provides personal care to people living in supported living houses in and around Scarborough. The service specialises in supporting younger adults and older people who may be living with a learning disability or autistic spectrum disorder, a physical disability, mental health needs or a sensory impairment. Thirty-seven younger adults and older people were using the service at the time of this inspection.

The service has been developed and designed in line with the principles and values that underpin

Registering the Right Support and other best practice guidance. This ensures that people who use the

service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the

need for people with learning disabilities and/or autism to live meaningful lives that include control, choice,

and independence. People using the service receive planned and co-ordinated person-centred support that

is appropriate and inclusive for them.

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

People received person-centred support from caring staff. Staff were respectful and kind in how they supported and encouraged people.

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. Staff were very skilled in how they offered people choices and supported them to make decisions. Accessible information was used to help people understand options and make decisions. We made a recommendation about record keeping in relation to the Mental Capacity Act 2005.

People’s needs were thoroughly assessed, risks identified and then their care and support planned in a way which maximised their independence whilst supporting them to stay safe. People and their relatives were involved in planning and reviewing the support provided to make sure it met their needs and personal preferences.

Staff were well trained and supported to provide effective care to meet people’s needs; they accessed a wide range of training and received regular supervisions and an annual appraisal. Staff monitored people’s health and wellbeing and supported them to attend appointments and seek medical attention if they became unwell.

People enjoyed the company of the staff who supported them and felt safe with the support they provided. Staff were trained to safeguard people from the risk of abuse or avoidable harm. Medicines were managed and administered safely. Accidents and incidents were monitored to make sure lessons were learned if things went wrong.

People were supported to take part in a wide range of activities and enjoyed the opportunities to try new things and pursue their hobbies and interest. Staff were proactive in how they supported and encouraged people to maintain their independence.

People felt able to speak with staff or management if they were unhappy or needed to complain.

There was a person-centred culture within the service and this was reflected in how the care and support was organised and delivered to meet people’s needs and improve their quality of life. People were actively engaged in developing the service and in driving improvements. Meetings, surveys and engagement groups were used effectively to encourage people to be involved in shaping and improving how the service was run.

There was open communication and management were responsive to feedback and suggestions. Audits helped management monitor the quality and safety of the service and identify when improvements could be made.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection

At the last inspection service was rated good (report published 20 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

The service had a registered manager. 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.

This inspection was prompted in part by notification of an incident following¿ which a service user died whilst on holiday two months prior to the inspection visit. This incident was subject to police enquiries and as a result this inspection did not examine the circumstances of the incident. A Coroner's Inquest into this matter will follow.

However, the information shared with CQC about the incident indicated potential concerns about the management of risk when people took part in activities whilst receiving support away from their home but supervised by staff. This inspection examined those risks.

We found risks had not always been fully assessed or risk management plans put in place to ensure people were protected from harm. This had been a breach of regulation which had been rectified by the time of this inspection. We have made a recommendation regarding on going review of risk.

We found the provider’s systems around risk management had not been robust enough and did not include thorough risk assessment when a person went on holiday. The provider had not recognised this and this had placed people at risk of harm. Once alerted to this the provider had responded and implemented a new system which was in place at the time of this inspection.

At the inspection staff were able to tell us what they would do to ensure people were safe and people told us they felt safe when being supported by the service.

Medicines were safely handled to protect people.

The service had sufficient numbers of suitable staff to care for people and staff were safely recruited. People were protected by the infection control procedures carried out by staff.

Staff had received training to ensure that people received care appropriate for their needs. Training was up to date across a range of relevant areas.

Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and they understood the principles of the MCA and DoLS. People were supported and protected around their mental capacity.

People’s nutrition and hydration needs were met. People enjoyed the meals and they had choices around their meals and snacks.

People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with dignity and respect.

Staff had knowledge and understanding of people’s needs and worked well together as a team.

Care plans provided detailed information about people’s individual needs and preferences. Care plans were kept up to date when people’s needs changed, and people were encouraged to take part in drawing up their care plans, their reviews and to give their views which were acted upon.

Records and observations provided evidence that people were treated in a way which encouraged them to feel valued and cared about.

People were supported to engage in daily activities they enjoyed and which were in line with their preferences and interests. Staff were responsive to people’s wishes and understood people’s personal histories and social networks so they could support them in the way they preferred.

People told us their complaints were responded to and the results of complaint investigations were clearly recorded. Everyone we spoke with told us that if they had concerns they were always addressed by the staff who supported them or by the registered manager if they raised concerns with them.

The registered manager provided staff with support to carry out their role. They had a clear understanding of their own role. They consulted appropriately with people who lived at the service, people who mattered to them, staff and health care professionals in order to identify and act on required improvements.