Background to this inspection
Updated
11 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 28, 29 and 30 November 2018 and was announced. We gave the service 48 hours’ notice of the inspection site visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. This was the first inspection of this service.
The inspection was carried out by one inspector who visited the office location on 30 November. On 28 November we spoke with four care staff over the telephone and on 29th November we spoke with three people who used the service in their homes.
Before the inspection we looked at all the information that we had about the service. This included information from statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted professionals working with the service for their views.
We looked at the documentation in relation to two people using the service and looked at three staff files. When we visited the office, we spoke to the registered manager and one of the service managers. We also reviewed information relating to how the quality and safety of care was monitored by the registered manager. Prior to the inspection we received feedback from one health care professional who was working with the service.
Updated
11 January 2019
This was an announced inspection that began on 28 November 2018 and finished on 30 November 2018.
Mencap – North Norfolk Domiciliary Care Agency provides care and support to people with learning disabilities and autism. At the time of the inspection it was providing support to eight people. The service is a domiciliary care agency. It provides personal care to people with learning disabilities living in their own houses and flats in the community. This service provides care and support to people living in ‘supported living’ settings so that they can live in their own home 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 regulated activity is provided across four houses which are part of a wider service of eight houses in North Norfolk. People have their own tenancies in shared houses, with their own bedroom and shared communal spaces such as kitchen, living room and dining room. Staff provide support at the property according to contracted hours. The support is either one to one, or shared with other tenants in the property. Sleep in support is provided overnight at each of the houses. At the time of the inspection there were eight people using the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service is run by 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 felt safe and looked after by the staff at Mencap – North Norfolk Domiciliary Care Agency. Staff had a good understanding of how to safeguard people from abuse.
Risks were assessed and managed well to support people in carrying out daily living tasks and supporting people to lead an active life in the community.
There were procedures in place to help protect against employing staff who were unsuitable to work in the service. There were enough staff to meet people’s needs. Staff worked flexibly across the service to cover staff absence ensuring people were supported by people who knew them.
Staff were trained in the administration of medicines and could describe how to do this safely. There were robust auditing procedures in place to make sure that all procedures were followed and people received their medicine as it had been prescribed.
Incidents and accidents were recorded and reported to managers who monitored these through an online system. Learning from incidents and accidents was used to improve the service for the future.
Care plans were detailed and person centred. They provided the information that staff needed to support people to live their life as independently as possible. Staff received the training they needed to provide them with the skills and knowledge required to support people. Managers regularly checked the competency of staff in carrying out their role. Staff were supported through regular supervisions and annual appraisals.
Systems were in place to support people with eating and drinking. This was appropriate to the needs of individuals, so where full support was required with specialist diet this was monitored closely. Where people were more independent they were supported to take part in preparing meals for themselves.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.
Staff were kind and caring. There was a person centred ethos that promoted people’s independence across the service. People were supported to live fulfilled lives, to pursue interests and hobbies and to take part in their local community. People had choice about where they lived and who they shared a house with.
The service responded to people’s needs. Care plans were regularly reviewed and kept up to date. Pictures were used as communication tools across the service to help people express their views and make choices. Staff knew people well and supported people to pursue their interests.
There was a robust complaints procedure in place. People knew who they should speak to if they wanted to make a complaint. They were confident that their concerns would be dealt with.
The service had supported people at the end of their life and was working with people using the service to plan in advance to make their wishes and feelings known.
The service was well led. Staff and people spoke positively about the management of the service. There were robust governance systems in place.