Archived: FUN Domiciliary Care Agency

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 continued to receive a good service. People were kept safe from harm by appropriately recruited and trained staff. Risks to people's health and wellbeing were addressed and mitigated.

People were supported with their medicines and to maintain cleanliness within their homes.

Staff were well trained and supported by the management team. Staff worked well with other health and social care professionals to enable good outcomes for people. People were supported to maintain a healthy and balanced diet.

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.

People were cared for by staff who treated them with kindness, dignity and respect. People were supported to maintain caring relationships with people who knew them well. People's independence was respected and encouraged as far as possible. People received care which was person-centred and responsive to their needs.

People knew how to make a complaint and felt confident they would be listened to. Regular audits took place to measure the success of the service and to continue to develop it. People, staff and the registered manager described a culture which focussed on people and ensuring they received good care.

Staff worked well with other health and social care professionals to support people. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last Inspection: The last rating for this service was Good (published February 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 reinspection programme. If we receive any concerning information we may inspect sooner.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were safeguarded from abuse because the service had good processes in place to ensure staff knew how to respond appropriately to any allegation of abuse. All staff had attended safeguarding training to ensure they had a good understanding of their roles and responsibilities, if they suspected abuse was happening. Staff knew who to contact to ensure people were protected.

People were supported by a sufficient number of suitably experienced and knowledgeable staff and there was a 24 hour on call service. .

The provider had ensured there were appropriate staff recruitment checks carried out on potential staff before they started work at the service. Staff had been recruited using a laid down policy and procedure which included how new staff were supported through their induction to the service. Once employed the service provided its staff with organised training opportunities throughout the year as arranged by the manager. This gave the staff the opportunity to learn new skills and to keep their knowledge up to date.

There were systems in place to manage medicines and people were supported to take their prescribed medicines safely.

Staff knew people well and were skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. People, where able, were involved in the planning and reviewing of their care and support. Daily notes were written in an informative style and were up to date.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When a person lacks mental capacity to take particular decisions, any decisions made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

Unfortunately, the service had not correctly applied the Deprivation of Liberty Safeguards (DoLS), This was because people were living in their own home and hence the service should have worked with the Court of Protection. However appropriate mental capacity assessments and best interest decisions had been undertaken and the impact was minimal. As soon as the manager became aware of this situation, corrective action was set about with regard to talking to the people concerned, families, relevant professionals, staff meetings and arranging further staff training.

Staff were aware of what people enjoyed to eat and drink and worked with them to purchase and then prepare meals. Each person was registered with professionals in the local area such as GP’s and Dentists to meet their needs and also specialist for complex needs.

Positive and caring relationships had developed between people and staff. The staff on duty knew people well and throughout the times we visited we observed positive interactions between people using the service and staff. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were given choices in their daily routines. We saw that people enjoyed days out and pursued their own interests. One person was very proud of their vehicle and worked with the staff to keep it clean.

People were supported to maintain relationships with friends and family so that they were not socially isolated. There was an open culture approach by the management and staff were supported to provide care that was centred on the individual. The support plans were written in a person-centred style and there was clear involvement of the person themselves and their families.

People and relatives told us they were supported to report any concerns or complaints and they told us they felt they would be taken seriously. People who used the service were encouraged to be involved in decisions about the service. The support plans were reviewed yearly and as required in response to changes in a person’s condition. The provider had systems in place to check the quality of the service and took the views and concerns of people and their relatives into account to make improvements to the service.

Is the service safe?

When we arrived at the service the staff on duty asked to see our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

staff training records showed that people had been suitably trained in the tasks required to provide the required quality of care to people who used the service. We saw evidence of good personalisation of furniture in the kitchen which enabled all people who used the service to have access to the equipment and facilities. We also saw that the service had a detailed set of policy documents and risk assessments relating to the cleanliness of the environment and infection control.

We saw evidence, in the form of rotas, that staffing levels had been assessed and identified on the basis of what levels of staffing were appropriate to the current needs of people who used the service.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Is the service effective?

People's needs were fully assessed by the service before people moved in to the service, and this assessment was used to inform the level and type of support people received.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Is the service caring?

Observations made during the inspection showed that there were friendly, respectful and supportive relationships in place between staff and people living in the home. We observed staff assisting people in the activities of daily living with due regard for privacy and choice on the part of the person using the service.

Staff spoke with people in a kind way to respectfully preserve the person's dignity when providing care and personal assistance. We saw evidence, in the form of weekly plans which confirmed people who used the service had access to their preferred amount and type of activities.

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and behaviour management specialists.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service completed regular reviews of documentation to monitor a number of key areas which included; care issues, medication, finances and health & safety. The home also had regular visits from the responsible individual to ensure that the home was delivering safe and effective care. The manager was able to describe a number of changes and/or alterations to the service which had resulted from feedback from people who used the service or their representatives. As a result the quality of the service was continuingly improving.

We observed people spending time at chosen activities and noted that there was good interaction between the people who used the service and staff. There was a relaxed and calming atmosphere in both services. People told us that they were able to choose what they wanted to eat and when. One person told us, 'I am happy here, I do a lot of activities'.

We saw that people using this service were safe, well cared for by responsive and well led staff. People received care and support according to their assessed needs. We found that records relating to people who used the service provided an accurate reflection of their needs. However where people may not have had capacity to consent to their care, support and where required treatment the provider had not procured professional assessments as to the persons mental capacity, in accordance with the legal requirements and principles of Mental Capacity Act (MCA).

We found that there were enough skilled and experienced staff to meet people's needs. Staff told us that they had received appropriate training and spoke knowledgably about the people they provided care and support to. Systems were in place to assess and monitor the quality of the service that people received.

We found that the service was meeting people's individual needs. People were supported to take part in a wide variety of activities according to their wishes. Staff assisted people to be as independent as possible and this included menu choice, where to go during the day and support with self medication. Risk assessments were in place to ensure people's safety. Care plans were detailed and specific to the needs of each individual. Staff had received training which was relevant to the needs of the people they cared for. They spoke competently about the care they delivered and were motivated to provide a service that supported people to achieve their potential and realise their own goals.