Archived: Teeside Domiciliary Care Office

Teesside Domiciliary Care provides support to adults with learning disabilities both within supported living services and in domiciliary care settings. They provide personalised support packages tailored to meet the individual's needs. At the time of the inspection they were providing personal care for nine people.

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

Medicines were administered safely. There were enough staff to ensure people were safe. Plans were in place to manage risks associated with people's health and wellbeing, whilst ensuring people could remain independent. Staff had received training to safeguard people from abuse and knew how to report concerns. The management team sought to learn from any accidents or incidents involving people.

People's care was person centred and was responsive to their individual needs. Staff had received training to understand how to support people well. Care records provided information in relation to people's backgrounds, interests and care needs.

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; systems supported this practice. The registered manager ensured care was based upon good practice guidance to help ensure people received an effective service.

Promoting independence was encouraged and people were offered choices.

The registered manager and staff team worked closely with external healthcare professionals to ensure people's health and wellbeing was maintained.

There was a clear management structure and staff were supported by the registered manager. Quality assurance systems were completed.

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

Rating at last inspection and update

The last rating for this service was good (published 9 May 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.

Teesside Domiciliary Care provides support to adults with learning disabilities both within supported living services and in domiciliary care settings. They provide personalised support packages tailored to meet the individual's needs. At the time of the inspection they were providing personal care for five people.

At the last inspection on 14 and 15 January 2016 we found improvements were required. We found that risk assessments were not always in place for people using the service and care workers. Identified risks were not always acted on. Each person had a person centred plan which showed how they wished to be supported but these would benefit by adding further detail. Although staff demonstrated an understanding of the Mental Capacity Act 2005 they had not received training. Food hygiene training was also needed.

We found the service in breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and made a recommendation regarding when required medicines. We rated the service as ‘Requires Improvement’ overall and two domains required improvement.

At this inspection we found that the team had worked collaboratively to ensure the previous breach of regulation was addressed and the recommendation was implemented.

The registered manager left in November 2016 and a new manager is currently applying to become registered. 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.

Due to people’s communication needs we were unable to gain some of their views about the service and therefore we spoke with other people close to them.

People who lived at the service told us staff were caring and kind. Staff encouraged people to be involved with communal activities but respected their decision if they did not want to participate.

The service had detailed safeguarding and whistleblowing policies in place which provided information about how to recognise the signs of abuse, and how to respond to any concerns.

Individual risk assessments were in place to support people with promoting their independence and safety. In addition to individual risk assessments, the service also had a range of environmental risk assessments. People’s support plans were specific and centred around their individualised support needs. Support plans were up to date and were regularly evaluated .Staff knew people and were knowledgeable about people’s care and support needs.

The service had safe systems in place to ensure people were supported with managing their medicines appropriately. People were supported with promoting their health and nutrition.

Records within staff files demonstrated proper recruitment checks were being carried out. These checks include employment and reference checks, identity checks and a disclosure and barring service check (DBS). A DBS check is a report which details any offences which may prevent the person from working with vulnerable people. They help providers make safer recruitment decisions. Staff were supported with regular training opportunities that linked to the care and support needs of people living in the service.

Staff received mandatory training in a number of areas, including food hygiene. This assisted them to support people effectively, and were supported with regular supervisions and appraisals. People’s rights under the Mental Capacity Act 2005 were protected.

People were supported to carry out health and safety checks within their own flats.

People using in the service and their representatives were provided with information to support them to raise any concerns or complaints they may have. People told us the manager and staff were approachable.

The service had a quality assurance system which included a range of internal checks and audits to support continuous improvement. Action plans were put in place to address any shortfalls in service provision and to demonstrate how areas of improvement were addressed.

The service had a registered manager who had been registered with the Care Quality Commission since November 2015. 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 service also had a service leader who managed the day to day running of the service.

Teesside Domiciliary Care provides support to adults with learning disabilities both within supported living services and in domiciliary care settings. They provide personalised support packages tailored to meet the individual's needs 24 hours a day seven days a week. At the time of our inspection they were providing personal care for five people.

Due to people’s communication needs we were unable to gain some of their views about the service and therefore we spoke with family members or other person close to them.

Risk assessments were not always in place for people using the service and care workers. Identified risks were not always acted on.

There were systems and processes in place to protect people who used the service from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected.

Staff were trained and competent to provide the support individuals required. Although staff demonstrated an understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards, they had not received training in this area . Training was also needed in food hygiene. We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people. Staff had now started to receive regular supervision and appraisals, these had not taken place for the majority of 2015. The service leader was aware of this and had put a system in place.

We found that appropriate systems were in place for the management of most medicines. People were supported with their medicines by suitably trained and experienced staff. We have made a recommendation regarding when required medicines.

The service had a system in place to monitor accidents and incidents.

The service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. At the time of our inspection no one was subject to a Deprivation of Liberty Safeguards.

The registered provider carried out assessments to identify health and support needs of people. Each person had a person centred plan which showed how they wished to be supported. We found that these would benefit by adding further detail. People were supported to maintain good health and have access to healthcare professionals and services.

From discussions with a relative and documents we looked at, we saw people who used the service or their families were included in planning and agreeing to the care provided at the service. People had individual support plans, detailing the support they needed and how they wanted this to be provided. Staff reviewed plans at least monthly with input from the person who was supported.

Staff demonstrated they knew; the people they were supporting, the choices they had made about their support and how they wished to live their lives. All this information was documented in each individual care plan.

People were supported to access activities of their choice.

A complaints procedure was available and people we spoke with said they knew how to complain, although no one said they had needed to. The service maintained records of compliments and complaints and recorded how these were resolved.

There were effective systems in place to monitor and improve the quality of the service provided.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.