Voyage (DCA) (East)

The inspection took place on 05,11,19 and 23 July 2018 and was announced.

The service was last inspected in December 2015 and had an overall rating of Good. At this inspection we found the evidence continued to support the rating of good.

At the time of the inspection there was a registered manager in place. 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.

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.

Staff were aware of how to keep people safe from harm and what procedures they should follow to report any harm. Action had been taken to minimise the risks to people. Risk assessments identified risks and provided staff with the information they needed to reduce risks where possible. Systems were in place to promote and maintain good infection prevention and control.

Medicines were managed safely. Staff received training and their competency to do this was checked before staff could administer people’s medicines unsupervised.

Staff were only employed after they had been subject to a thorough recruitment procedure. There were enough staff employed to ensure that people had their needs met. Staff received the training they required to meet people's needs and were supported in their roles.

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 and worked within the guidance of the Mental Capacity Act 2005.

Staff were motivated to provide care that was kind and compassionate. They knew people well and

were aware of their history, preferences, likes and dislikes. People's independence, privacy and dignity were respected and promoted.

People were supported to maintain good health as staff had the knowledge and skills to support them. There was prompt access to external healthcare professionals when needed.

People were provided with a choice of food and drink that they enjoyed. When needed staff supported people to eat and drink.

Support plans gave staff the information they required to meet people’s care and support needs. People received support in the way that they preferred and met their individual needs.

There was a complaints procedure in place. People and their relatives felt confident to raise any concerns either with the staff or manager. Complaints had been dealt with appropriately.

There was an effective quality assurance process in place which included obtaining the views of people that used the service, their relatives and the staff. Where needed action had been taken to make improvements to the service being offered.

Further information is in the detailed findings below.

As part of this inspection we spoke with six people who used the service, two relatives, two healthcare professionals who had regular contact with the home, the registered manager and six members of care staff. We reviewed records relating to the management of the service which included; six care plans, daily records, safeguarding procedures, training records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at

Is the service caring?

People told us that they received consistent and respectful support from care staff and felt able to make choices and changes when required. Care staff told us that they were well supported and supervised so that they could provide safe care and support to people.

Is the service responsive?

We saw that people's personal care and support needs were assessed and met. This also included people's individual choices and preferences as to how they wanted their care to be provided. People we spoke with told us that they could make changes to their support and had been involved in reviews of their care. Relatives that we spoke with also confirmed that they had been involved in reviews. We saw that changes to documentation were made to accurately reflect the support being provided by care staff.

Is the service safe?

Risk assessments regarding people's individual needs were carried out and measures were in place to minimise these. Care staff understood their roles and responsibilities in making sure that people were protected from the risk of abuse. We saw that the provider was taking appropriate action to ensure that all carers were kept up to date with safeguarding training.

Is the service effective?

We found that carers were knowledgeable about people's individual care and support needs. People who used the service that we spoke with, and their relatives, confirmed that care staff provided consistent support both in their own home and when accessing the community. The manager confirmed that measures were in place to ensure that reviews of care and support documentation were in place to meet people's assessed needs.

Is the service well led?

Staff that we spoke with told us that they felt well supported by the management team. They told us that there was regular training so that they could safely provide care and support. People that we spoke with told us that they felt they were listened to and that support was consistently and safely provided. Quality assurance systems were in place to regular audit the care and services it provided. Surveys were carried out to gather opinions from people who used the service, relatives and staff to ensure that ongoing improvements could be made.

We reviewed 12 people's plans of care. We found that for each person a record was held that the person agreed to their care. We also saw that arrangements were in place to provide care where it was in the person's best interests.

People's care records were detailed and provided staff with sufficient information and guidance to safely provide each person's care. People's assessed health risks were recorded and reviewed on a regular basis. People were provided with care that was based upon their most up-to-date care information.

Four relatives we spoke with were all positive about the quality of care that had been provided. One relative said, "They (staff) are wonderful. They have made such a difference to my (relative's) life."

Staff recruitment procedures were found to be effective. The provider only employed staff whose suitability and fitness to work with vulnerable people had been assessed.

Of the few compliant records, all had been responded to promptly and to the satisfaction of the complainant. One relative we spoke with said, "I speak regularly with the home's manager about any minor concerns but I have never had to complain formally."

The records we viewed also showed us that staff were provided with regular safeguarding training which meant that people were protected from abuse. People were also able to submit a 'care card' (a means by which someone who lacks capacity can report abuse) should they require any help or protection.

From the records we reviewed we saw that people were able to decide what they wanted to do, when and how they wished to do this. People had their aspirations recorded in their plans of care which showed us what people could do and how they were going to achieve this.

People's medicines were kept safely and were administered by competent staff, and audits were conducted regularly to ensure that medicines administration was without error.

Staff were supported to achieve further skills and qualifications in health care and received regular and meaningful supervisions and annual appraisals.

The provider gathered information about the quality of service provided and used many different communication methods to ensure that people who used the service were equally able to contribute to improving the service.