Archived: Mencap Domiciliary Care Essex

Royal Mencap Society - Domiciliary Care Services - South London is a supported living service providing personal care to 25 people, many of whom have learning and physical disabilities, autistic spectrum disorder and mental health needs. People supported by the provider were aged between 30 and 65 at the time of the inspection.

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

Quality assurance processes were in place, but required reviewing to ensure their effectiveness. This included monitoring of staff fitness for their role. Staff had guidance required for their role, but they were not always provided with the necessary mandatory training courses to meet their role expectations. We made recommendations about this.

Although people had comprehensive risk management plans in place, information was not always available on how likely the risks were to occur. There wasn’t always enough staff to support people with going out on the activities of their choice. Records related to people’s end of life wishes and mental capacity assessments were not always completed appropriately. The management team told us that these areas of concern would be addressed immediately. We will check their progress at our next comprehensive inspection.

Pre-employment checks were carried out before staff were recruited by the provider. Staff reported their concerns as necessary if they noticed people being at risk of abuse or when incidents and accidents took place. People had support to manage and store their medicines safely.

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. Staff supported people to meet their health needs as necessary which supported their well-being. People had a choice to prepare their meals separately from their housemates and were assisted with their meal preparations as necessary.

People received excellent care from staff who were open and compassionate towards their role responsibilities. They provided emotional support which enabled people to follow their religious believes and express themselves in the way they wanted to. There was a comprehensive level of support provided for people to help them plan their care and the support they required to achieve their desirable outcomes. People were encouraged to use resources available in the community, so they could lead independent and fulfilling lives.

Care plans were individualised and met the needs of people using the service. Complaints received were investigated appropriately and according to the provider’s policies. Family members were asked for regular feedback, so the management team could improve the service and the experience of people.

The service followed the provider’s set values which promoted open and transparent culture within the staff team who supported people with their everyday needs. There was a supportive leadership at the service who aimed to encourage staff to develop in their role, so they could provide a person-centred care for people. The service used external resources to keep them up-to-date with the changes taking place in legal requirements.

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 outstanding (published 21 April 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.

This service provides personal care and support to people living in supported living schemes across the London boroughs of Croydon, Lambeth, Lewisham, Merton and Sutton. Supported living is a model of social care where people rent their homes from a housing provider and receive an agreed amount of care and support hours from a separate care provider according to their individual needs. At the time of our inspection there was a total of 44 people using the service. There was a registered manager 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.

People had built very good relationships with staff, who were friendly and respectful and who knew people well. The service used creative and innovative methods of supporting people to express their views and make choices about their care, including the use of accessible technology where needed. This included additional support for people who were able to communicate verbally but found it difficult to express their wishes for other reasons.

The service had a strong commitment to promoting people’s independence. Staff worked closely with people to build their confidence and learn to do more for themselves. People had access to adapted equipment according to their individual assessed needs to enable them to carry out daily living tasks independently.

The provider used a person-centred approach to care planning based on evidence-based measures of quality of life. Support plans were personalised and centred around people’s preferences, views and experiences as well as their care and support needs. They took into account people’s history, family relationships and religious and cultural needs. People’s care and support was planned in such a way as to facilitate working towards their goals and ambitions. The provider recognised people’s achievements and encouraged them to always improve by setting new targets whenever their care was reviewed.

People received support to engage in a variety of activities to suit their tastes and abilities, both at home and in the wider community. This included taking more responsibility for their own household tasks but also pursuing their interests and hobbies, making new friends and finding new interests. Staff supported people to pursue education and employment opportunities and to join social groups.

People were satisfied with how the service responded to their complaints and concerns. There was an accessible complaints procedure and records showed the registered manager dealt with complaints according to the procedure.

The provider had a visible person-centred culture with a clear vision and strong values, which staff were familiar with and knew how to apply to their work. Leadership was accessible and people, staff and others involved with the service had opportunities to express their views about the service. Managers used people’s feedback to improve services in a variety of ways.

The registered manager used several tools to assess, monitor and improve the quality of the service including internal audits carried out by people who used similar services operated by the same provider. They assessed the quality of the service against standards that were based on people’s feedback about the care and support they wanted from services. People were also involved in the recruitment and selection of new staff. The provider worked to challenge discrimination and stigma in recruitment, for example by guaranteeing an interview to all applicants who identified as being disabled.

Staff knew how to keep people safe, because there were detailed risk management plans to reduce risks. Staff supported people to make sure their homes were safe. They received suitable training in safeguarding people from abuse and there were procedures in place to protect people from financial and other abuse. Medicines were managed safely.

There were enough staff to keep people safe and appropriate arrangements for emergency staff cover. Recruitment processes were designed to ensure only suitable staff were selected to work with people.

People benefited from being cared for by staff who received suitable, good quality training that was relevant to their work. Staff received regular support from managers and had opportunities to learn and discuss good practice with their colleagues.

Staff were aware of their duties under the Mental Capacity Act 2005. They obtained people’s consent before carrying out care tasks and followed legal requirements where people did not have the capacity to consent.

Staff supported people to choose food they liked and to eat healthily. People received enough food and fluids to remain healthy and staff monitored this when required. People had adapted equipment to help them eat independently, if they needed it. People had detailed plans to help staff and health professionals provide the care and support they needed to remain healthy and manage any existing health conditions.