The Care Quality Commission
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Archived: Voyage (DCA) North Yorkshire

Overall: Good read more about inspection ratings

Room 11a, Community House, Portholme Road, Selby, North Yorkshire, YO8 4QQ 07793 616700

Provided and run by:
Voyage 1 Limited

All Inspections

23 November 2016

During a routine inspection

This inspection took place on 23 November and 1 December 2016. We gave the registered manager 48 hours’ notice of our visit so that people would be available to speak with us.

The last inspection took place on 10 and 22 September 2015. At that inspection Voyage (DCA) North Yorkshire we made two recommendations regarding staffing and quality assurance. We found that the overall rating for this service at the time to be requires improvement.

Voyage (DCA) North Yorkshire is registered to provide personal care to adults living with a learning disability. People are supported by staff to live in small groups in independent supported living schemes. Different levels of support are provided over the 24 hour period according to people's individual requirements. During our inspection the service supported 13 people who lived in four shared houses.

There was a registered manager. 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.

At this inspection we found improvements had been made. Additional staff had been recruited to ensure people received consistent care and this enabled them to take part in their individually planned activities and enhanced their overall well-being.

Staff had been trained in safeguarding topics. The registered manager had a good understanding of safeguarding processes and followed these in practice. Thorough recruitment processes were followed before staff started work. This reduced the risk of unsuitable people being employed.

Risk assessments and risk management plans were in place to protect people from avoidable harm. Assessments contained detailed guidance for staff about how to minimise the risk of harm whilst protecting people’s rights and freedoms

Medicines were safely managed. Medicine records were completed correctly, and checks of these were undertaken on a regular basis. This meant if any errors were noticed they could be addressed quickly.

People were supported by well trained, skilled staff. Staff supervision, meetings and appraisals were taking place on a routine basis, which meant staff had the opportunity to reflect on and develop their practice.

We found that people were encouraged to exercise choice and control in every aspect of their lives. People were supported to make their own decisions wherever possible, and during our visit we observed staff supporting people to choose what they did with their time. Where people were unable to make a decision there was a best interest decision recorded within their support plan and we saw the person and relevant people had been involved in making this. This meant people were given the opportunity to be involved in decision making and decisions were made in the person’s best interests.

There was access to a varied and balanced diet and people were encouraged to be involved in the planning and the preparation of their meals. People were supported to access their health care appointments to make sure they received appropriate care and treatment.

Good personal and professional relationships existed and we observed staff took care to maintain people’s privacy and dignity. People told us that staff were caring, kind and friendly. We saw that staff were focused on the person and what was important to them.

Staff were knowledgeable about the people they supported. This was confirmed in the feedback we received about the service. People had comprehensive care and support plans in place. These guided staff on people’s preferred approach to meet their care needs. For example, one person liked staff to pass them their medicines to take independently.

People were supported to follow their individual interests and pursuits including working in local community organisations. People understood how to make complaints and information on how to make a complaint was displayed.

There was clear leadership and management at this service. The registered manager was described as approachable and part of the team. Senior managers promoted the values of the service and we saw that they led by example.

The provider undertook a range of audits to check on the quality of care provided. People were encouraged to discuss future goals and aspirations and how they were going to achieve these.

10 and 22 September 2015

During a routine inspection

This inspection took place on 10 and 22 September 2015 and was announced.

The last inspection took place on11 June 2013 and the service was meeting the regulations we assessed.

The service provides supported living to people in their own homes. People who use the service have learning disabilities, autism or mental health difficulties. At the time of our inspection the service supported fourteen people who lived in four shared houses.

The service did not have a registered manager. They had left in July 2015 and the organisation was recruiting to the post. In the interim the operations manager had taken on some of the registered manager’s role and responsibilities. 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.

At this inspection we found the service was in breach of one regulation which related to management oversight of the service and how the service monitored the quality of support provided. You can see what action we told the provider to take at the back of the full version of the report.

The service did not have a registered manager in post; the operations manager was providing some management oversight. Staff told us they were supportive and approachable. This meant there was limited oversight of the issues across the service, specifically in relation to staffing.

Audits were not consistent or robust and it was difficult to get a sense of the issues within the service and how these would be addressed.

The service had a number of staff vacancies. This meant staff were doing additional hours, or bank staff were being used. Staff expressed their frustration at the organisations failure to retain staff and described staff developing their skills, and getting to know people and then moving onto other care organisations. Although people were not at risk of harm they were not always able to take part in their individually planned activities which may impact on their general well-being and quality of life.

When new staff were recruited we saw the service had robust checks in place to ensure they were suitable to work with people who used the service.

People who used the service and their relatives told us they felt safe and staff knew how to protect people from avoidable harm. Risk assessments and risk management plans were in place. They contained detailed guidance for staff about how to minimise the risk of harm.

Medicines were safely managed. Records were completed correctly, and a stock check took place on a regular basis. This meant if any errors were noticed they could be addressed quickly.

Staff described feeling well supported. Despite this we did not see evidence of supervision taking place on a routine basis, particularly for team leaders. This meant staff did not have the opportunity to reflect on and develop their practice.

People received support from staff who had access to appropriate training and knew how to meet people’s needs. A lot of the staff we spoke with had worked for the service for a number of years and knew people well.

Staff had a sound understanding of the Mental Capacity Act and we saw consent was sought routinely. People had been supported to make their own decisions wherever possible, and staff had taken steps to support people to do this. For example we saw in one person’s support plan that there was a best time of day recorded for when the person would be best able to make a decision. Where people were unable to make a decision there was a best interest decision recorded within their support plan and we saw the person and relevant people had been involved in making this. This meant people were given the opportunity to be involved in decision making and decisions were made in the person’s best interests.

People had access to appropriate healthcare professionals and had a health action plan. This meant people’s health care needs were being appropriately supported.

There was access to varied and balanced diets, people were involved in planning and, where possible, making meals.

The service was caring. People knew staff well, and staff were described as, “kind, caring and smashing.” Staff knew people well and ensured their preferences for support were met. Support plans contained detailed person centred information which provided staff with instructions about how to support people but also gave them a sense of what was important to the person.

People were supported to be as independent as they could be and some people worked in local community organisations. Activities were planned and person centred, however not everyone had equal access to individual activity due to staffing issues.

People and their relatives understood how to make complaints and we looked at two complaints which had been responded. These had been resolved to the complainant’s satisfaction.

11 June 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because some of the people had complex needs which meant they were not able to tell us their experiences.

We spoke with the relatives of three people who told us they were happy with the service. Comments included 'I am satisfied with the care my relative receives.' And 'My relative has their needs met. In fact it is probably over and above what they need. The carers know them well.'

We found in the records we reviewed, people or those acting on their behalf, were helped to understand the care options available. We saw written records of 'What was important to them, now and in the future'. These showed that people or their representatives were able to express their views about care and treatment.

People were protected against the risks associated with medicines because appropriate arrangements were in place to ensure these were managed in a safe way.

We reviewed the recruitment and selection processes and found them to be robust. This ensured that people were supported by suitably qualified, skilled and experienced staff.

This was the first inspection of the agency. We saw they had put systems in place to make sure people were safely cared for. This included policies and procedures, induction training for staff and quality monitoring systems.