14 October 2019
During a routine inspection
Affinity Trust - Domiciliary Care Agency - South is a care agency, providing personal care to people living in supported accommodation and their own homes. At the time of the inspection the service was supporting 32 people living in six supported living settings. Five of the supported living settings were located in Surrey and one in Portsmouth. Five of the settings were single locations which supported between one and three people in a property. The provider supported a further two people living in their own homes.
The sixth setting had been commissioned by a local authority in two phases which had been set up over the last two years. The care and support supplied to people by the provider, was completely separate from the accommodation people rented. The sixth setting had been a former care home which had been closed and re-configured to create separate properties by the commissioning authority. This setting accommodated 21 people on one-site with between one and five people living in each property. The complex was larger than good practice guidance recommends. However, people’s properties were staffed separately and two on-site support managers managed the two phases separately.
The service has been developed 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
Overall medicines had been safely managed. There had been issues with medicines errors at the sixth setting. The provider had taken extensive and robust actions to address this for people, but it will take further time for them to be able to demonstrate their full effectiveness.
The provider had processes and systems in place to protect people from abuse and to investigate any incidents at the appropriate management level and to take any relevant action required. Staff assessed individual risks to people and monitored their safety. The provider had ongoing concerns about the compatibility of people living in one property in the sixth setting which they had raised with commissioners.
There were sufficient numbers of suitable staff deployed. It had taken time in the sixth setting to establish a completely new, large workforce across the different properties with the required skills and knowledge. The provider had experienced issues with consistency of on-site management with the second phase of the sixth setting and had ensured throughout there was senior management cover in place, whilst a suitably experienced manager was appointed.
People’s needs were assessed and the delivery of their support was in accordance with legislation and guidance. Staff were provided with the required skills and knowledge for their role. Staff ensured people ate and drank enough to maintain a balanced diet. Staff worked with each other and across agencies to deliver effective care and to promote people’s health and welfare.
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 treated people with kindness, respect and compassion. People were involved by staff wherever possible in decisions about their care. Staff upheld people’s privacy and dignity during the provision of their care.
People received personalised care that was responsive to their needs. Staff were able to support people at the end of their lives.
The provider promoted a positive culture. People who used the service, their relatives and staff were engaged and involved with the settings. There were processes and systems in place to drive improvements. Staff used any concerns or issues raised as an opportunity to improve the service. The provider worked in partnership with other agencies, openly and honestly
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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 opportunities 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 8 November 2017)
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.