Background to this inspection
Updated
6 April 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.
This was a targeted inspection to check on a concern we had about safeguarding people from the risk of abuse.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service also provides care and support to people living in 4 ‘supported living’ settings, so that they can live 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 inspection looked at people’s personal care and support.
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 not a registered manager in post. There was a manager in post who had applied to become the registered manager.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 23 February 2023 and ended on 10 March 2023. We visited the location’s office on 23 February 2023 and a supported living service on 28 February 2023.
What we did before the inspection
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 reviewed information we had received about the service. We used all this information to plan our inspection.
During the inspection
We spoke to 3 relatives about their views on the care and support provided. We spoke to 8 staff including the manager. We reviewed a range of records. This included 3 people’s care records. We looked at 4 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
6 April 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Voyage (DCA) Somerset & Devon is a domiciliary care service providing personal care and support to people with additional needs such as learning disabilities and autism. At the time of inspection, 21 people were receiving support across eight services, including shared homes and self-contained flats.
People’s experience of using this service and what we found
Right Support
¿ The service supported people to now have the maximum possible choice, control and independence and they had control over their own lives. We were told staffing had previously impacted people’s support and the provider had recognised this so been undertaking recruitment drive.
¿ The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.
¿ The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. However, this had not always been the case due to the COVID-19 pandemic restrictions creating delays in refurbishment. Also, unstable management in the past not always liaising with the housing providers.
¿ People had a choice about their living environment and were able to personalise their rooms. Some people were proud to show us how they had personalised their rooms and flats. This included using posters, choosing colours and bed linen.
¿ Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
¿ Staff supported people to play an active role in maintaining their own health and wellbeing. However, there were occasions when staff levels meant people’s preferences were not always met. The management were in the process of addressing this including through recruitment.
Right Care
¿ Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
¿ People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
¿ Staff understood how to protect people from poor care and abuse. The service worked in partnership with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to follow the principles.
¿ The service had not always deployed enough appropriately skilled staff to meet people’s needs and keep them safe. This had led to inconsistencies in people’s care and support. The new management had recognised this issue so were actively resolving it with a recruitment drive and targeting training where it was required.
¿ People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. However, the recently appointed manager had identified that further work was required on training staff to communicate using a wider range of methods.
¿ People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
¿ People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. The provider representatives and manager had recognised this had not always been the case due to inconsistent management. They had clear plans for further improvements.
¿ Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture
¿ People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Past inconsistencies had been recognised by the manager and systems were being put in place to rectify this and improve communication.
¿ People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. Past shortages and inconsistent management had been identified by the provider’s systems and were in the process of being rectified.
¿ The provider’s systems recognised people had not always been supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. The new management were already rectifying this situation.
¿ Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. This had recently been impacted by use of agency staff and high turnover of staff.
¿ Staff placed people’s wishes, needs and rights at the heart of everything they did.
¿ People and those important to them, including advocates, were involved in planning their care.
¿ People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
We received concerns in relation to staffing, management of the service and concerns in relation to people’s support. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Voyage (DCA) Somerset & Devon on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.