Archived: Selby Domiciliary Care Agency

This service is a domiciliary care agency. The service supports people living with a learning disability and autistic spectrum disorder in their own homes or a supported living environment.

Not everyone who used the service received personal care. The Care Quality Commission (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. Nine people were receiving personal care in supported living settings at the time of this inspection.

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 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, relatives and staff were positive about the way the service was led. People benefitted from effective managements systems and an established management team, which promoted their wellbeing and safety.

They were asked what worked well and what changes they would like to see. The provider and the registered manager checked the quality of care provided. Managers worked with other agencies such as social housing landlords and healthcare professionals to make sure people’s needs were met and drive continuous improvement.

Care and support were based on people’s care preferences and considered how staff could minimise identified risks while also supporting people’s individual freedoms and choices. 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 supported this practice.

People spoke positively about the care and support they received. They told us they liked the staff and said they were kind and caring. People we visited were comfortable with staff who supported them. Staff spoke with people in a respectful way and supported people to maintain their dignity.

Staff received appropriate training and support to provide effective care. Care plans provided detailed information about people’s needs to support staff to provide person-centred care. People knew who to speak with if they had any worries or concerns. Staff knew how to help people who became anxious or upset including the best way to support people with their health appointments.

People followed their interests and took part in activities including in the wider community. Where appropriate, people had access to education and work opportunities.

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 14 December 2016).

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.

We last inspected Selby Domiciliary Care Agency on 29 July 2014 as part of the new inspection process introduced by the Care Quality Commission (CQC), which looked at the overall quality of the service. At that inspection Selby Domiciliary Care Agency was meeting all of the legal requirements. We found the overall rating for this service to be good.

Selby Domiciliary Care Agency is registered to provide personal care to adults with a learning disability. People are supported by staff to live individually in their own homes or in small groups in independent supported living schemes. Different levels of support are provided over the 24 hour period according to people's individual requirements. Before our visit the registered manager told us there were 19 people who were in receipt of personal care from the service.

There was a 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.

People told us they felt safe. Thorough recruitment processes were followed before staff started work. This reduced the risk of unsuitable people being employed.

People were supported by well trained, skilled staff.

We found that people were encouraged to exercise choice and control in every aspect of their lives. Relatives were involved in best interests meetings for people who required additional support with decision making. Any risks were identified and action was taken to minimise these and to reduce the potential risk of harm to people whilst protecting their rights and freedoms.

People had food and drink to meet their needs. People were supported to access their health care appointments to make sure they received appropriate care and treatment.

We observed good relationships existed between people who used the service, relatives and staff. Staff were knowledgeable about the people they supported. This was confirmed in feedback we received about the service.

People had comprehensive care and support plans in place. These guided staff on people’s preferred approach to meet their care needs. One example of this was how one person liked to take their medicines independently.

People told us they were actively involved in the community and this was helping to improve their access to local services and raise awareness. We were told that members of the police and the fire service had met with people who had specific care needs. This was an important factor in making sure that people did not experience any discrimination and unequal treatment which may result in their needs not being recognised or met in an emergency.

A complaints procedure was in place. People confirmed they knew who to speak to if they had any worries or if they were upset. Relatives said they had not raised a complaint but said they knew how to if needed. They felt they would be listened to and managers would act upon any concerns raised with them.

The provider undertook a range of audits to check on the quality of care provided. People were asked for their views and their comments were used to celebrate success and identify improvements. One example was the reflection days where people could discuss what was working well and what they would like to change. This was a positive way for people to pause and take stock annually, to discuss future goals and aspirations and how they were going to achieve these.

We found that people were included in decisions about how their care was provided and their preferences and wishes respected. People had care plans and risk assessments in place which helped staff to understand and meet people's needs.

People told us they were very satisfied with the support they received. One person said 'It's a joint effort we work together and I get on really well with my support workers.' Another person said 'The staff are great, I get the help I need.'

The provider had responded appropriately to allegations of abuse and had appropriate policies and procedures in place which defined what constituted abuse and provided information for staff about the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

We spoke with staff who told us that the agency was very supportive, particularly with regards to emergency out of office support. They told us they provided good opportunities for training to equip them with appropriate skills and experience.

There was a complaints procedure in place which included an easy read accessible format for people with communication difficulties.

We spoke with three relatives of people who used the service, via the telephone. One relative said 'He has a good social life and his days are filled.' We were also told 'The staff are very good. We feel he is very safe living there.'

We observed the people who used the service were at ease when the staff members were present in the office. We saw they had good personal relationships and communicated well with other people who used the service.

We spoke with five members of the care team. They told us how they would protect the people they cared for. We saw the service had policies and procedures in place to support the care staff and the people who used the service from actual or potential abuse.

We reviewed the complaints policy. This was in an easy read format so all people were aware of how to raise concerns if they wished. We saw the service annually reviewed people's 'satisfaction' of the service.