23 November 2023
During an inspection looking at part of the service
St Anne's Community Services - Leeds DCA is a domiciliary care agency providing support and personal care to people in their own homes. The service provides care to people with a learning disability or autistic people. At the time of the inspection, the provider told us 45 people were receiving support with personal care from the service.
People's experience of using this service and what we found
Right Culture:
The providers quality assurance and governance systems in place to assess, monitor, and improve the quality and safety of the services provided had failed to identify the issues we found during this inspection.
Right Support:
Medicines were not always managed safely. Documentation relating to covert medicines was not in place. Risk assessments did not always include detailed information about people’s 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; the policies and systems in the service supported this practice.
Right Care:
Staffing levels were sufficient to meet people's needs. Systems were in place to safeguard people from the risk of abuse and people told us they felt safe with the staff who supported them. Incidents and accidents were reported, investigated and measures taken to mitigate future occurrences. However, we did identify 5 incidents which were not reported to CQC.
People and their relatives knew how to complain and felt comfortable raising concerns with the provider. People and their relatives told us they were happy with the support they received. Staff felt supported by the management team and were provided with regular supervisions.
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 23 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified a breach in relation to the management oversight. We have made a recommendation about medicines.
Please see what action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.