One Step Domiciliary Care

Updated 31 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service type

This service provides care and support to people living in one ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. This was also because the service is small, and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We spoke with two healthcare professionals as part of our planning for this inspection to seek their views on the quality of care provided. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with two people who used the service and visited one person in their home. We spoke with two people’s relatives about their experience of the care provided. We spoke with six members of staff and the registered manager.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager. We also sought further evidence from people’s relatives and health professionals on 02 and 09 July and 23 July 2019 to validate the evidence found.

Updated 31 October 2019

About the service

One Step specialises in providing personal care and support for people who live with a learning disability, in their own home and when out in the community. At the time of the inspection there were 10 people receiving support with their personal care.

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/or 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

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.

People were all provided with an excellent person-centred service which was very responsive to their needs, wishes and preferences. Management and staff had an extremely positive impact on people's lives and went above and beyond to understand and respond to people's needs and preferences. When planning people’s care, staff supported people to express themselves. Staff also helped people to fulfil their wishes and aspirations.

People were supported by sufficient numbers of staff who were recruited following a robust recruitment process. People felt safe and staff were aware of how to keep people safe from avoidable harm. Staff reflected on errors to ensure they learned lessons from incidents. People received their medicines when the prescriber intended and they were protected from the risk of infection.

Staff felt supported by all levels of management and were able to develop their skills to meet the needs of people. Staff received appropriate training and could develop within their role. People’s nutritional needs were assessed and supported, and people were encouraged to make healthy meal choices. People were all able to see healthcare professionals when needed, and staff worked collaboratively and in partnership with other agencies.

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.

People told us staff were caring and sensitive to them and they had formed meaningful relationships with staff. People and their relatives told us they felt involved in reviews of their relatives care and were listened to. People’s dignity and equality was maintained.

There was strong sense of leadership in the service that was open and inclusive. People benefited from a robust professional management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met.

Regular feedback from people who used the service, relatives, care staff and professionals were gathered through questionnaires, regular face to face meetings and at staff team meetings. People knew how to raise any concerns or complaints and their feedback was used to make improvements to the service. People were introduced to lay advocates if necessary. Regular quality assurance checks were in place to monitor the quality and safety of care that people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 08/06/2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

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.