Drama Room

Updated 1 November 2023

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 Health and Social Care Act 2008.

Inspection team

One inspector and an Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care

Service and service type

Drama Room is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was 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 the 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed 5 people's care files, 3 staff files in relation to recruitment, and other documents such as supervision, staff rota, medicines, and a variety of records relating to the management of the service. we spoke with the registered manager, 2 senior workers and the Nominated Individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We contacted 11 professionals and received feedback from 1. We sent a questionnaire to all staff and received a response from 12. We spoke with 4 people and 5 relatives.

Updated 1 November 2023

About the service

Choice Global (Drama Room) is a domiciliary care service providing personal care and support for people in their own homes. At the time of the inspection the service provided support to 15 people.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Medicines were not always managed safely. Care plans were not always person centred and did not provide consistent information. This meant staff did not always know important information about people. There was limited information recorded in risk assessments to guide staff to care for people safely. Staff understood how to safeguard people from the risk of harm and people told us they felt safe.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. People told us they felt staff needed more training as they often had to show people how to care for their loved ones.

We were not assured peoples nutritional and hydrational needs have been assessed as there was limited information record about people’s needs. The provider was not carrying out assessments before they started to deliver care. People did not receive person centred care.

The provider did not have effective quality assurance systems in place to monitor, manage and improve service delivery.

People were happy with the care they received, and they felt the service was well managed.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 April 2019). The service remains rated requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Drama Room on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches of regulations in relation to person-centred care, consent, safe care and treatment, staffing and good governance. We made a recommendation to the provider to review their call monitoring process to ensure people receive their care in line with their agreed care packages.

We have sent a Regulation 17(3) Letter to the provider in relation to their failure to effectively operate systems and processes to assess, monitor and improve the quality and safety of the services provided in carrying on the regulated activities. A Regulation 17(3) Letter stipulates the improvements needed to meet breaches of regulation, seeks an action plan and requires a provider to regularly report to CQC on their progress with meeting their action plan.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.