About the servicePark View Domiciliary Care agency is registered as a domiciliary care agency, but it was clear at inspection that people needing personal care support were living in three shared tenancies as part of a supported living set up, where staff were available on site if needed 24 hours a day.
People with learning disabilities were supported to live in their own tenancies across three shared houses. The office for the service is based in one of the shared houses is open during office hours and an on-call system is available to staff based in the houses out of hours. Sleep-in rooms are provided in each house for staff to ensure support is provided 24 hours per day.
At the time of our inspection the service was providing personal care to eight people across the three shared houses in Deal. 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.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
People's experience of using this service and what we found
Staff said they were well supported. Improvement was needed however to maintenance of records of staff supervision and appraisal; to demonstrate that staff training development and performance needs were being addressed.
The provider was a visible presence in the service and had good oversight of the service, but had not developed a system of quality monitoring to provide assurance that all aspects of the service were working well, and people were safe. This is an area for improvement.
People felt safe and were treated well by staff who showed compassion and kindness.
One person was able to tell us that they felt safe and secure in the knowledge that staff were onsite 24 hours each day. Most people were not able to give good feedback about their experiences due to communication issues, but we observed them to be relaxed and comfortable in the company of staff and actively sought their attention. We spoke with a relative and care manager who commented positively about the service.
People were protected from the risk of harm because staff had received appropriate training knew how to report and act on concerns, accidents and incidents to keep people safe.
There were enough staff to support people. Staff continuity was good and meant people were able to build relationships with staff that knew them well and how they preferred to be supported. There was a safe system of recruitment in place to ensure suitable staff were employed. Staff always said they felt supported. The provider was visible in the service daily and staff found them approachable and available to discuss issues and keep them informed.
People’s health care needs were supported to maintain their health and wellbeing.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Policies and procedures were in place to support and guide staff practice.
No formal complaints had been received and people were encouraged to raise any concerns.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was Good (published 25 January 2017)
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make some improvements. Please see the Well Led section of this full report. We found no evidence during this inspection that people were at risk of harm from this.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.