Background to this inspection
Updated
3 January 2018
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.
This inspection took place on 30 November, 5 and 8 December 2017 and was announced. We gave the service 48 hours’ notice of the inspection visit to ensure the registered manager was available to assist us with the inspection. The inspection was carried out by two inspectors.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at information we held about the service. This included previous inspection reports and notifications we had received. Notifications are certain events that providers are required by law to tell us about. We reviewed the responses to a questionnaire we sent out to 14 people of which three were returned, 70 staff of which 13 were returned and 10 community professionals of which two were returned. In addition, we contacted the local authority to obtain their views on the service.
During our inspection we visited both the service’s office and two supported living locations. Not everyone using the service were able to share their experiences of the care provided so we observed the support people received in communal areas.
We spoke with two people, five care staff, one team leader, a support manager and the registered manager. During the inspection we looked at seven people's care records, four staff files, medicine records and other information relating to the management of the service.
Updated
3 January 2018
We undertook an announced inspection of Affinity Trust - Domiciliary Care Agency Southend and Essex on 30 November, 5 and 8 December 2017.
The service provides care and support to people with physical disabilities, learning disabilities and/or autistic spectrum conditions, living in supported living settings such as shared or self-contained accommodation. Supported living accommodation enables people to 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. At the time of our inspection, 34 people were being supported by 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.
At our previous inspection in July 2016, we rated the service 'Requires Improvement'. We found the service in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because not all staff had been provided with specialist training to enable them to have the correct skills and knowledge to provide effective care to people. At this inspection we found improvements had been made and the service was no longer in breach of this regulation.
The service embraced the principles that underpin the ‘Registering the Right Support’ and other best practice guidance; these include choice, promotion of independence and inclusion. The registered provider was signed up to the Driving Quality Code to drive up quality in services for people with learning disabilities that goes beyond minimum standards. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Although the service had systems in place to assess the quality of the service provided, improvements were required to some areas of quality assurance to ensure record keeping was consistent and to a good standard. We have made a recommendation in relation to the quality of record keeping.
People were safe. Staff understood their responsibilities in relation to safeguarding and received relevant training. There were systems in place to notify the appropriate authorities where concerns were identified. Where risks to people had been identified risk assessments were in place and action had been taken to manage these.
Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Staff were aware of people's individual needs and followed guidance to keep them safe. People received their medicine as prescribed. The service had safe recruitment processes and there were sufficient numbers of staff to meet people's care and support needs.
Staff had a good understanding of the Mental Capacity Act (MCA) 2005 and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves.
People were treated as individuals by staff committed to respecting people's individual preferences; the service's diversity policy supported this culture. Care plans were person centred and detailed people's preferences and the outcomes they wanted to achieve. People were supported to maintain relationships with friends and families and encouraged and supported to pursue their hobbies and interests. A complaints policy and procedure was in place and information on how to raise any concerns or complaints were available in alternative formats such as pictorial and large print.
The registered manager demonstrated strong values and commitment to learn and implement best practice, ensuring people had a good quality of life. Staff were motivated and proud to work at the service and were positive about the support they received from management. Staff supervision and meetings were scheduled, as were appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.