Drama Room

Choice Global (Drama Room) is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support to 15 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Medicines were not always managed safely. Care plans were not always person centred and did not provide consistent information. This meant staff did not always know important information about people. There was limited information recorded in risk assessments to guide staff to care for people safely. Staff understood how to safeguard people from the risk of harm and people told us they felt safe.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. People told us they felt staff needed more training as they often had to show people how to care for their loved ones.

We were not assured peoples nutritional and hydrational needs have been assessed as there was limited information record about people’s needs. The provider was not carrying out assessments before they started to deliver care. People did not receive person centred care.

The provider did not have effective quality assurance systems in place to monitor, manage and improve service delivery.

People were happy with the care they received, and they felt the service was well managed.

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 requires improvement (published 18 April 2019). The service remains rated requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Drama Room on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulations in relation to person-centred care, consent, safe care and treatment, staffing and good governance. We made a recommendation to the provider to review their call monitoring process to ensure people receive their care in line with their agreed care packages.

We have sent a Regulation 17(3) Letter to the provider in relation to their failure to effectively operate systems and processes to assess, monitor and improve the quality and safety of the services provided in carrying on the regulated activities. A Regulation 17(3) Letter stipulates the improvements needed to meet breaches of regulation, seeks an action plan and requires a provider to regularly report to CQC on their progress with meeting their action plan.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

Care plans were developed when people started using the service. However, risk assessments had not always been developed for each identified risk and lacked detail and guidance for staff. Staff demonstrated verbally they knew people well and were aware of how to manage people’s individual risk.

Care plans were person centred and took account of people’s preferences. However, the care plans lacked the detail on how to provide the care and support listed. Staff we spoke with were aware of how to provide the support in the way people wanted.

The registered manager was very involved in the day to day support and care of people who used the service. However, the auditing and monitoring of the service needed to improve. Audits and checks were not always in place to ensure best practice.

People felt the care and support they received was safe. Staff received training in safeguarding and they knew how to report their concerns internally and externally to safeguarding authorities.

Relatives told us people could rely on staff coming to visit them, we found that calls were delivered on time and the registered manager allocated travel time between calls.

Staff received regular training, the registered manager observed their practical knowledge and competencies. Staff received appropriate training to meet people’s needs.

Relatives told us they were happy with the care provided for people by Choice Global.

Relatives told us the registered manager was approachable and listened to them, they felt confident to raise any concerns. Concerns or complaints were recorded and responded following the provider`s complaints policy.

Relatives told us staff were kind and caring towards people who used the service. People`s dignity and privacy were protected.

Staff were responsive to people’s needs and supported them the way they wanted.

The provider had policies and procedures in place which were based on current legislation and best practice guidance. Staff received updates when required to ensure lessons were learned when things went wrong.

Rating at last inspection: This was the first inspection of the service since the service registered with the Care Quality Commission on 30 November 2017.

Why we inspected: This was a planned inspection.

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