6 December 2022
During an inspection looking at part of the service
About the service
St Elizabeth's Domiciliary Care is a supported living service for people with learning disability and autism. The service was provided to adults in shared accommodation on their college site and in individual flats.
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. At the time of the inspection 26 people were supported with the regulated activity.
People’s experience of using this service and what we found
Right Support
Staff did not always support people with their medicines to achieve the best possible health outcome. The provider did not ensure they had robust systems in place to manage medicines, however this was actioned immediately during the inspection.
People were supported to have choice and control of their lives and staff attempted to support people in the least restrictive way possible and in their best interests. However, there needed to be further development with documenting where decisions were made in people’s best interest and where people may lack capacity.
Staff adhered to safe practices when wearing personal protective equipment (PPE).
Right Care
People had care plans and risk assessments; however, these were not always clear and coordinated. The management team were updating these during the inspection.
People had enough appropriately skilled staff to meet people's needs and to keep them safe. Further development was needed where staff needed to use different methods of communication to support people.
Staff were starting to understand, and responded to, people's individual needs. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to to help promote people’s safety and wellbeing. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right Culture
People's quality of support was not always enhanced by the quality assurance system the provider had in place. Actions were not always documented, and it was unclear if actions were completed to improve the service
The management team had put systems and development plans in place to drive improvement and share lessons learnt from the previous inspections.
People did not always have risk assessments in place, to identify risks people faced and how staff should manage these.
People were supported by staff who understood best practice in relation to supporting people with a learning disability and autism.
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 inadequate (published 05 August 2022). At this inspection we found improvements had been made, however the provider remained in breach of regulations.
This service has been in Special Measures since 02 March 2022. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall. Therefore, this service is no longer in Special Measures.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.
We undertook this focused inspection to check they had followed their action plan and to follow up on intelligence we had received about the service. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for St Elizabeth's Domiciliary Care Agency on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to medicine management, risk management and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.