This was an announced inspection carried out on16 August 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. Our last inspection at Learning Disability Domiciliary Care Agency took place in June 2017. At that inspection, we found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 12; Safe care and treatment and Regulation 17; Good governance. Following the last inspection, we asked the registered provider to complete an action plan to show what they would do and by when to improve the key question safe and well led to at least good.
At this inspection, we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirement of these regulations.
This service is a domiciliary care agency. It provides personal care to people with a learning disability living in their own houses and flats in the community.
Not everyone using Learning Disabilities Domiciliary Care Agency receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
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
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.
Safeguarding procedures were robust and staff understood how to safeguard people they supported. People had individual risk assessments in place so that staff could identify and manage any risks appropriately. The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.
Recruitment Procedures were in place but there were some inconsistencies in staff files. The registered manager took immediate action to address this concern.
We have made a recommendation that the registered provider review their recruitment policy.
Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.
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.
We saw that people’s care plans contained information about the type of decisions people were able to make and how best to support people to make these decisions.
People were supported with their health and dietary needs, where this was part of their plan of care. Staff were aware of the people who needed a specialised diet.
Staff we spoke with told us they felt supported. Staff underwent an induction and shadowing period prior to commencing work, and had regular updates to their training to ensure they had the skills and knowledge to carry out their roles. Although some staff told us they would like further training in positive behaviour support.
We have made a recommendation about staff training on the subject of positive behaviour support.
People were treated with dignity and respect, and their privacy was protected. During the inspection we observed staff giving care and assistance to people. They were respectful and treated people in a caring and supportive way. Staff spoken with could describe people’s individual needs, hobbies and interests, life history, people’s likes and dislikes.
The service provided information to people using the service in an easy read format to help people to be able to use it.
The quality and safety of the service was effectively monitored and improved when required.