29 November 2023
During an inspection looking at part of the service
Portland Domiciliary service is a supported living service which was supporting 11 people at the time of the inspection. The service can support up to 12 people. The service comprises of 12 purpose-built bungalows.
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.
People’s experience of using this service and what we found.
Right Support
The service didn’t always make reasonable adjustments for people so they could be fully in discussions about how they received support, including what staff they had to support them. The provider had enough staff to keep people save. However, there was a high use of agency staff and agency staff members were not always consistent.
Staff supported people to make decisions following best practice in decision-making. However, some aspects of peoples support plans, regarding positive behaviour support plans to help people when they were anxious, were not always followed.
The provider didn't always support people to have the maximum possible choice and control to be independent over their own lives. People were encouraged to set targets and in some areas of life for example, gaining more independence. However, this wasn’t consistent and steps to achieve goals were not clear for staff to follow.
We have made a recommendation regarding outcomes for people.
Medicines were managed and administered safely. However, records and systems to monitor medicines, needed to be improved. Staffs’ competency to administer medicines was checked. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome.
The provider supported people to be safe in their own homes, with fire safety checks and people had personal evacuation plans. The provider gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People’s bungalows were personalised.
Right care
People had enough staff to meet their needs and keep them safe. However, inductions and checks on agency staff were not always in place. People were not always supported by person centred practices. Failure to induct agency staff properly, meant they didn’t have the right information to support people in a personalised way. People did not always receive consistent care from a staff team who knew them well.
People were encouraged to take positive risks. Risk assessments were in place for people. The provider acted to protect people from abuse. Staff knew how to report any concerns to the appropriate places. Staff had training on how to recognise and report abuse.
Right culture
People and those important to them, were not always involved in planning their support. The provider didn’t always enable people where appropriate to work with staff to develop the service. The service was treated as a whole at times and not as individuals living in their own bungalows.
We have made a recommendation regarding engaging people in planning the service.
People didn’t always lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People were not always supported by staff who understood best practice in relation to the wide range of strengths or sensitivities people with a learning disability and/or autistic people may have. Staff teams were not always consistent therefore didn’t always know people well enough to be supporting their aspirations.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection and update
The last rating for the service was good, published on 12 July 2018.
Why we inspected
This inspection was prompted by a review of the information we held about this service and due to the length of time since the previous inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Portland Domiciliary service on our website at www.cqc.org.uk
Enforcement
We have identified breaches in relation to managing accidents and incidents , records, staffing, and manager oversight at this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.