East Anglia Domiciliary Care Branch

People’s experience of using this service:

¿The management team had a good oversight of the quality of the service provided. We have recommended that the provider review its formal quality monitoring systems to ensure these are fit for purpose and provide robust support to the management team.

¿People received safe care and support provided by caring and consistent staff who knew them well.

¿Careful recruitment meant the staff group had shared positive values and were committed to providing good quality care.

¿People were supported to be healthy, this included where people received support with food and drink.

¿People were involved in the assessing and planning of their care; their consent was sought and people felt in control.

¿People received individual care that met their specific needs and preferences.

¿The service was well led, people and staff were engaged and involved in the running of the service.

Rating at last inspection: At our last inspection, the service was rated "good". Our last report was published on 28 July 2016.

Why we inspected: We inspected this service in line with our inspection schedule for services currently rated as Good.

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 information is received that we need to follow up we may inspect sooner.

A registered manager was in post. 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 inspection was carried out on 30 and 31 March 2016.

The safety of people who used the service was promoted and enhanced by staff who had received training in safeguarding procedures. Staff had been recruited safely to ensure that they were appropriate to work with vulnerable people.

The service ensured that sufficient numbers of suitable staff were deployed to keep people safe and meet their needs.

Staff received appropriate and ongoing training to ensure that they had the skills and knowledge to meet people’s needs. Staff were well matched to meet people’s needs and had developed caring and positive relationships with them.

People received their medicines safely and as prescribed. The service maintained a good overview of the medicines records to identify any errors or omissions that might indicate additional training needs.

Risks to people’s wellbeing were identified and care plans devised to minimise their impact without unnecessarily restricting their freedom.

The service had a good understanding of the Mental Capacity Act (MCA) where it was appropriate within this service. People were enabled to express their wishes and preferences for how their support was delivered.

People were supported to have enough to eat and drink and maintain a healthy diet.

Care plans were comprehensively compiled, personalised and regularly reviewed to ensure that they reflected the current needs of people who used the service.

People were supported to express their views and were involved in decisions about how their care was delivered. People were treated with dignity and respect and their independence was promoted by the service.

The service responded appropriately to concerns and complaints and people were supported to express their views about the service.

The registered manager ensured the quality of service by carrying out regular audits where people were supported by the service.

The registered manager ensured their visibility in the service by talking to people when they carried out quality checks and by organising and attending inclusive social events for people who used the service.

As part of this inspection we spoke with four people who used the service, the registered manager and three members of staff. We also reviewed records relating to the management of the home which included, four care plans, daily care records, training records and support/supervision records of staff.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

We spoke with four people who used the service. They told us that their care and support was good and that they were safe.

We looked at four sets of care records which included risk assessments. Measures had been put in place to minimise any risks to people who used the service that ensured they were supported safely. For example, the risks to people's health through malnutrition, risks when outside the service they lived in and the risk of overspending had all been assessed and the care records we looked at showed how those risks had been minimised.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care services. While no applications had needed to be submitted, policies and procedures were in place and under review. Relevant staff had been trained to understand when an application might be necessary and how to submit one.

We discussed staffing rotas which showed that there were sufficient numbers of trained and competent members of staff employed to provide people with safe and appropriate care as planned.

Is the service effective?

People who used the service were treated with dignity and respect. We observed staff who were providing support to people. They spoke appropriately to people who used the service and were aware of people with communication difficulties and the best ways of communicating with them. For example, by using sign language or pictures when explaining things or offering choice.

People who used the service were supported in making choices. For example, what to wear or what main meal they preferred. Where people found it difficult to make choices for themselves, staff supported them in making decisions based on best interest principles.

Quality assurance measures were in place to identify the effectiveness of the service. This included questionnaires given to people who used the service, relatives, staff and visiting professionals. We saw audits of infection control measures, care and staff records, medication records, and the premises and environment. We saw that easy read documentation was used for people with difficulties in reading or understanding written documents. For example, their complaints procedure was in all the care plans in an easy read format.

Is the service caring?

We saw that people were cared for in an appropriate manner. Staff were attentive to their needs and familiar with people's likes and dislikes. Records we looked at showed that people's needs had been assessed and details of likes, dislikes, routines and preferences were recorded.

The care records were based on person centred principles and individualised to meet the needs of the person in understanding and being involved in their care plan.

Is the service responsive?

The records we looked at showed that people's needs, choices and personal preferences had been assessed and planned for. Staff we observed during our inspection were familiar with each person and their individuality.

People's health and social care needs were attended to. People were supported to engage in a variety of vocational, social and recreational activities when they chose to do so. They were also supported to maintain contact with their friends and family members. A number of community based facilities were used to promote people's involvement in the community including day centres, the cinema, sports and recreational facilities.

Is the service well-led?

There were monitoring and reviewing systems in place to ensure that the quality of the care and support provided was high. Staff members told us that they had the training and support to safely do their job, which they said they enjoyed.

Members of staff and family members of people, who used the service, were provided with opportunities to make suggestions and comments to improve the quality of people's support and care. These were developed into an action plan which identified the improvements made and ensured that the service was able to confirm when required improvements were completed.

Staff we spoke with told us that they felt well supported and records showed that regular support and supervision was taking place.