Specialist Care Team Domiciliary Office

Updated 5 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.

We gave the service 24 hours’ notice of the inspection visit because we needed to be sure that someone would be at the office to support us with the inspection. .

Inspection site visit activity started on 04 December 2018 and ended on 12 December. It included two visits to the office, two visits to people who received domiciliary support and a visit to one supported living tenancy. We spoke with people who received support and staff to gather their views on the service. We did this through face to face and telephone conversations. The registered provider did not select and was unaware who the inspection team contacted by telephone.

The inspection team consisted of one adult social care inspector and one expert by experience. An expert-by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The experts by experience had experience of caring for older people who received support within a community setting.

Before our inspection, we checked the information we held about the Specialist Care Team. This included notifications the registered provider sent us about incidents that affect the health, safety and welfare of people who received support.

We also contacted the commissioning and contracts departments at Lancashire County Council. This helped us to gain a balanced overview of what people experienced when they received support from the Specialist Care Team.

We looked at information the provider sent us in the Provider Information Return. 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. All the information gathered before our inspection went into completing a planning document that guides the inspection. The planning document allows key lines of enquiry to be investigated focusing on any current concerns, areas of risk and good or outstanding practice.

We spoke with the registered manager, three members of the management team and five carers. We looked at the care records of 13 people; training and recruitment records of five staff members, records relating to the administration of medicines and the management of the service.

We looked at what quality audit tools and data management systems the provider had. We reviewed past and present staff rotas, focusing on how staff provided care within a geographical area. We looked at how many visits a staff member had completed per day and if the registered provider ensured staff had enough time to travel between visits. We looked at the continuity of support people received and how long staff stayed on each visit by reviewing the registered providers electronic call monitoring system.

We used all the information gathered to inform our judgements about the fundamental standards of quality and safety of the service delivered by the Specialist Care Team.

Updated 5 January 2019

The Specialist Care Team is a domiciliary care agency. It provides personal care to people who have mental health needs and/or people with a learning disability in their own houses and flats. It operates from premises in the centre of Morecambe.

This service also provides care and support to people living in four supported living settings, so 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 part of the inspection looked at people’s personal care and support.

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.” Registering the Right Support CQC policy

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good

The service had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. One staff member told us, “The training was good, you got the skills to support people.”

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

The service had safe infection control procedures in place and staff had received infection control training. Staff had been provided with protective clothing such as gloves and aprons as required. This reduced the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.

The registered manager planned visits to allow carers enough time to reach people and complete all tasks required. People told us they mostly had the same staff visit and relationships had developed. One person told us, “They are pleasant with me, when they come, and never miss a visit.”

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks to maintain people’s independence.

People were supported to have access to regular healthcare professionals and their healthcare needs had been met through scheduled and responsive support.

People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

The service had information with regards to support from an external advocate should this be required by people they supported.

People told us staff who visited them treated them with respect and dignity.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The service had kept a record of complaints received and these had been responded to appropriately.

The service used a variety of methods to assess and monitor the quality of the service. These included daily service meetings, quality assurance visits and care reviews.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

Further information is in the detailed findings below.