We inspected Affinity Trust – Domiciliary Care Agency – North on 16, 17 and 22 August 2016. This was an announced inspection because we wanted to ensure someone would be present at the service on the days of the inspection to provide us with the information we needed.The service is registered to provide personal care to people living in their own homes and to people who required support to access the community. At the time of our visit the service provided personal care to 27 people with learning disabilities and/or autistic spectrum disorder across the city of Leeds.
The service had an operations manager in post who had applied to become the 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.
Systems were in place for the safe management of medicines so people received their medicines safely. Some improvement was needed around the consistent use of ‘as and when ‘required protocols and those for creams and lotions.
The medication audit was not fully effective as it had not identified medication errors we found. However, the registered provider had already identified this and taken appropriate action.
There were systems in place to monitor and improve the quality of the service provided. Staff told us the service had an open, inclusive and positive culture.
Assessments were undertaken to identify people’s support needs. Support plans reviewed contained information about the person's likes, dislikes and personal choices and preferences.
There were risk assessments in place for people who used the service. The risk assessments and support plans had been reviewed and updated on a regular basis. Risk assessments covered areas such as mobility, medicines and independent access to the community. This meant staff had the written guidance they needed to help people to remain safe.
There were enough staff employed to provide support and ensure people’s needs were met. The rota system was flexible to ensure people could access activities of their choice at different times of the day.
Staff told us the managers were supportive. Staff received regular supervision sessions and an annual appraisal. The majority of staff were up to date with training and the registered provider had a system to monitor compliance in this area. Staff told us they had received training which had provided them with relevant knowledge and skills to provide care and support.
There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.
Effective recruitment and selection procedures were in place and we saw appropriate checks had been undertaken before staff began work.
The operations manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. MCA is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.
People and their families told us staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people. People told us they were supported to access a wide range of activities which helped them to build and maintain relationships.
People were provided with their choice of food and drinks which helped to ensure their nutritional needs were met. Staff at the service worked with other healthcare professionals to support people’s health and wellbeing.
The registered provider had a system in place for responding to people’s concerns and complaints. The procedure was available in an accessible format to support people to understand better. People told us they knew how to complain and felt confident staff would respond and take appropriate action.