Voyage (DCA) Norfolk

Updated 14 February 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. The inspector spent two days on site either in the office or visiting people in their own homes. The Expert by Experience spent a further two days contacting people by telephone to gather their views of the service they received. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The service provides domiciliary care within a supported living setting in which staff provide care and support to people living in housing tenancies. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

What we did before the inspection

Before our inspection we reviewed all the information we already held about this service, spoke with local authority commissioners and telephoned seven people and seven relatives to ask them their view. We reviewed any notifications we received on events the service is required to tell us about. We also reviewed other information including any other feedback received through our website, the previous inspection report and any safeguarding alerts. The provider completed a Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection

We spoke with the operational manager, the registered manager, the training officer, four staff members and three people came to visit us at the office. We reviewed care and support plans, staff files and other records relating to the oversight and management of the service. We visited nine people, observed their care and spoke with six staff.

After the inspection –

We continued to seek clarification from the provider and ask for additional information in a timely way.

Updated 14 February 2020

About the service

Voyage care is registered as a domiciliary care agency who provide care and support to people who have a physical and or learning disability. People have their own tenancies. The range of support varies according to people’s needs but some care packages are significant with 24 hours support in place, whilst others are just a few hours to support people in maintaining their independence. The agency also has a re-enablement service which provides intensive support for people who wish to live independently. The purpose of this service is to equip them with the skills they need to enable them to do so. The agency provided a service to many people but on the day of inspection 35 people were receiving a regulated activity.

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.

People’s experience of using this service and what we found

During our inspection we found people were happy and engaged well with staff supporting them. They talked eagerly about their plans for Christmas and their many trips out into the community. For those less able, staff ensured they were comfortable and provided them with excellent care, mental stimulation and support to do activities they enjoyed.

The agency carried out its role effectively with robust leadership and delegation. There were clear governance processes in place and the agency reviewed its performance against clear objectives. The agency had a clear business plan which identified areas for growth and improvement. This firmly established year on year improvements and reflected on people’s experiences.

People’s safety was given the highest priority and systems and processes helped to ensure that data was collated about any incidents or events affecting the safety and, or well- being of people using the service. Risk assessments were robust, and records showed clear actions taken to investigate the circumstances of an incident and consider what else could be put in place to lower the risk.

Safeguarding concerns were reported as appropriate and the agency operated in an open, transparent way, cooperating and sharing information with other health and social care agencies as appropriate.

Regular reviews of the care clearly established how the agency were operating effectively and in line with the necessary health and safety regulations. Audits viewed showed high compliance levels and the registered manager had oversight of all aspects of the service.

The agency delivered holistic care working in partnership with other services and health care professionals to ensure people’s needs were met as fully as possible. The organisation was very diverse in terms of the people it supported, and they ensured their workforce could meet the needs of people through good employment processes and training and development of its staff. We met people with rare medical conditions and staff had received bespoke training to enable them to meet their needs and educate others about their needs.

Staff helped to enhance people’s lives and give them confidence and opportunities to have useful, fulfilling lives. Clear care objectives were set and reviewed, showing how people were progressing and encouraged to be more independent, develop and maintain important relationships, life and work skills. Care and support plans were well written and gave an insightful view of the persons strengths and support needs. These were written and reviewed collaboratively.

People were supported to live healthy lives and access the services they needed to stay healthy. Staff regularly consulted health care professionals and reviewed medicines people were taking with the view of reducing or stopping medicines which were no longer necessary. There were robust systems in place to ensure people received their medicines as intended.

The agency had an individualised approach for each person they supported, and this included establishing people’s last wishes should they become ill and require palliative care. People’s needs were met sensitively, and people were supported to have a dignified death.

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; the policies and systems in the service supported this practice. 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.

The agency recognised people’s capacity to live their own lives and encouraged people to make decisions about their care and support, providing, where necessary additional tools and support to do this.

Rating at last inspection was good (published 5 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Voyage, (DCA) Norfolk on our website at www.cqc.org.uk.