92a

Updated 14 March 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection team consisted of one adult social care inspector.

Service and service type: Community Support Service (Dom Care) of Watford & District Mencap is a domiciliary care service. Staff deliver personal care support to people living in their own homes and in supported houses. Services are provided to adults and children with a learning disability and/or autistic spectrum disorder and other complex needs.

The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary service and the managers are often out of the office supporting staff and visiting services. We needed to be sure that they would be available to speak with us. We also needed to sure that people’s consent was gained for us to contact them for feedback about the service.

We visited the office location on 12 February 2019 to see the managers and office staff; and to review care records and policies and procedures.

What we did: Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us by other agencies. We also contacted commissioners who had a contract with the service.

During the inspection, we spoke with two people who used the service. We also had discussions with two staff members and the registered managers. We also received feedback from four health and social care professionals to gain their views on the service.

We looked at the care and medication records of two people who used the service, we visited the main office and two supported living houses.

We examined records in relation to the management of the service such as staff recruitment files, quality assurance checks, medicine reporting systems, staff training and supervision records, safe guarding information and accidents and incident information.

Updated 14 March 2019

About the service: Community Support Service (Dom Care) provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. They also provide a domiciliary service to people in their own homes. The service’s office is based in Rickmansworth and the support for people receiving personal care is in and around this area. 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. The service was supporting seven people who needed support with personal care who were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen ' Registering the Right Support' CQC policy.

What life is like for people using this service: People who used the agency told us they felt confident in the management team and how the service operated. They told us good staffing levels afforded people responsive and dignified support.

There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enabled people to live their lives as they chose.

People received their medicines safely.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life history, and their communication needs. They used this information to develop positive, meaningful relationships with people.

Staff were respectful of the fact they were working in people's homes. The service offered flexible support to people and could adapt to meet people's needs and support them as they wanted.

Where restrictions had been put in place to keep people safe this had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards. Any restrictive practices were clearly recorded and regularly reviewed to check they were still necessary and proportionate.

People were involved in planning their care and decisions about how care was delivered. Easy read information was provided to help people make informed decisions. Where necessary other supporting information was provided such as visual and audio materials. We observed people were in charge of their routines and were able to request support when they needed it.

Staff were recruited in a safe way and following a recent recruitment campaign, there were enough staff to meet people's current needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to ensure they were effective in their role.

People were supported to access health professionals when needed and staff worked closely with those professionals to ensure their health and social needs as well as their well-being was monitored.

The registered manager and provider worked well to lead the staff team in their roles and ensure people received a good service.

More information is in Detailed Findings below

Rating at last inspection: At our previous inspection the service was rated Good. (Report published 3 March 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection the service remained Good.

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