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Archived: Domiciliary Care Service Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 July 2018

The Domiciliary Care Service provides care and support to people living with learning disabilities in three ‘supported living’ setting, so that they can live in their own home 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. At the time of the inspection the service was providing support packages to 30 people, who lived in one of three supported living settings. Some people lived in shared houses and some people lived in their own flats.

At the last inspection, the service was rated Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Domiciliary Care Service’ on our website at www.cqc.org.uk

This inspection took place on 23 and 25 January 2018 and was announced. We gave the service seven days notice of the inspection site visits because it was possible that some of the people using the service might not have been able to consent to a home visit from an inspector, which meant that we had to provide time for any ‘best interests’ decisions to be made about this.

At this inspection we found the service Requires improvement. There was further work to do to make sure people were better supported to follow their interests and take part in activities that they liked, that were socially and culturally relevant and appropriate to them. This included having more access to the wider community.

In addition to the record of formal complaints, there was work to do to ensure that the more informal concerns people’s relatives raised and the action taken to address them were recorded, and managers made aware. Engagement with and listening to people’s relatives was an area for improvement. The absence of visible managers on a day to day basis in one supported living setting had led to a period when there was a lack of cohesion and there was work for the registered manager to do to address the issues arising as a result of this.

There was a registered manager 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 registered manager had recently returned to work after a six month absence and it was evident that her presence had been missed.

People who used the service were positive in their feedback and most of the relatives we spoke with said that on the whole their loved one’s day to day care needs were met. However, some relatives told us the service was going through a retendering process, which meant that a new provider was soon likely to be taking over the running of the service. There were enough staff available to ensure people were safe, although several staff had left and this had necessitated the use of bank and agency workers, who had taken time to get to know people.

We found that care and support was planned and delivered in a way that made sure people were safe. Systems were in place to safeguard people from abuse and the staff we spoke with knew how to recognise and report abuse. Risks associated with people’s needs and lifestyles were identified and plans were in place to minimise the risks. Medicines were managed safely and administered as prescribed.

We found that overall; staff were trained and had the skills they required to carry out their role. People received a healthy diet which they had been involved in choosing. People were supported to live healthy lifestyles and had access to relevant healthcare professionals as required. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

People were treated with kindness and compassion.

Inspection areas

Safe

Good

Updated 4 July 2018

The service remains Good.

Effective

Good

Updated 4 July 2018

The service remains Good.

Caring

Good

Updated 4 July 2018

The service remains Good.

Responsive

Requires improvement

Updated 4 July 2018

The service has deteriorated to Requires Improvement.

Well-led

Requires improvement

Updated 4 July 2018

The service has deteriorated to Requires Improvement.