Archived: Voyage (DCA) (North West)

Voyage (DCA) (Northwest) is registered to provide personal care to people in their own homes in the Wigan, St Helens, Ellesmere Port, Wirral and Crewe areas. People had varying degrees of support, including those with learning disabilities, acquired brain injury, autism and/or mental health needs. During this inspection 14 people were receiving support with personal care.

People using the service either lived in their own flats or houses and received support from staff over varied number of agreed hours. However, some people were living in ‘supported living’ settings and had access to staff support 24 hours a day. The supported living setting included seven single occupancy houses with sleeping facilities for staff. A separate office building was available within the row of houses located in a residential area in Wigan.

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

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff were motivated to deliver care and support that was person-centred and based on people’s needs and preferences. People were encouraged and supported to be as independent as possible. People’s needs and choices and had been assessed and planned for. Care plans identified intended outcomes for people and how they were to be met in a way they preferred.

People and family members spoke positively about the caring approach of the staff team and how well they knew people’s needs. Positive relationships had been developed between staff and people using the service. People and family members told us staff treated them with kindness, compassion and respect and observations showed that staff interacted well with people.

People told us they felt safe whilst being supported by staff and were confident they were well looked after. People living within the ‘supported living’ settings told us they felt safe because staff were available whenever they needed them. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.

Risks to people had been assessed and those identified were managed safely by competent staff. Where people required support with medication this was managed safely; people and family members confirmed that medication was received at the right times.

People were supported to access a range of social activities that were based on their interests and goals. Activities were used as a way to help develop independence, skill development and healthy living. People spoke positively about the activities they accessed and told us everything they did was their choice.

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 leadership of the service promoted person-centred care and a positive culture within the staff team. The newly recruited registered manager was open and transparent and had identified areas in need of improvement which had already been implemented. Positive comments had been received by people, family members and staff regarding the changes they had already made to the running of the service. Effective quality assurance systems supported with the continuous learning and development of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Voyage (DCA) (North West) is a domiciliary care service registered to provide personal care to people in their own home. At the time of our visit the service was providing support to three people who each lived in one of the six neighbouring properties owned by the service. The remaining three properties were vacant. The people using the service were adults who required a varying degree of support dependent on their individual needs.

The service had a registered manager in place. 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.

Peoples and their relatives told us they felt that care was delivered safely.

The service had an up to date safeguarding policy and whistle blowing procedure. Staff were aware of the action they should take if they suspected abuse was taking place and felt confident to report any concerns without fear of recrimination.

There were systems and processes in place to protect people from the risk of harm. People’s level of risk was assessed and where an elevated risk was identified a plan was put in place to provide care in a way that mitigated the risk.

Some people were being supported with their medicines and we saw that the service was storing these safely and recording them accurately. We also saw evidence of people being supported to manage their own medicine administration.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work.

Staff received appropriate training and had the skills and knowledge to provide support to the people they cared for. This included specialist training specific to the needs of the people using this service. New staff underwent induction training which included shadowing a more experienced colleague.

Staff received regular supervision and annual appraisals to monitor their performance. We saw evidence that these meetings had taken place and staff told us they found this support helpful.

Staff had a working knowledge of the principles of consent and the Mental Capacity Act and understood how this applied to supporting people in their own homes.

Staff worked alongside people to ensure they enjoyed a suitable, healthy diet and maintained a good level of nutrition and hydration. Menus were reviewed each week and produced following discussion with people.

Staff were very knowledgeable about the people they supported. They knew their likes and dislikes, encouraged independence and respected people’s privacy and dignity. We saw positive interactions between staff and people who used the service.

Staff were happy in their work and spoke positively about the care provided by the service. Relatives we spoke with felt that the staff delivered a good standard of care.

Care plans contained very detailed information about people’s individual needs and preferences. This meant that people received support tailored to them. People were involved in care planning and reviews and had regular meetings with staff to ensure care was continuously delivered in a way that best suited their needs.

People were supported to engage in a wide range of activities that were important to them and reviews of what was working well were regularly undertaken. We saw that the activities were specific to the individual’s interests.

The service had an up to date complaints policy in place and a clear, effective procedure for following these up. Staff were aware of how to support a person to make a complaint I they wished to.

Relatives told us they felt comfortable contacting the service with any issues and that they received a good level of communication from the service.

Staff felt supported by the registered manager. They found them to be approachable and felt able to voice their opinions or concerns. Staff meetings were held regularly and staff had access to minutes from those meetings they were not able to attend.

There were systems in place to monitor and improve the quality of the service provided. The management team carried out thorough comprehensive audits of the service every quarter. Other checks were carried out on a daily, weekly or monthly basis. An action plan was monitored by the registered manager and regularly reviewed by the operations manager. This ensured good management oversight of the service.

We found that there were appropriate arrangements in place for obtaining people's permission before care and support tasks were undertaken. We also found that people who were not able to make decisions for themselves were treated appropriately in line with the requirements of the Mental Capacity Act (2005).

We found that there were appropriate arrangements in place for obtaining, storing, administering and disposing of medicines.

There were effective recruitment procedures in place to ensure that suitable staff were employed within the service. There were appropriate numbers of qualified and experienced staff on duty to meet the needs of the people who were being supported by the service at the time of our inspection.

There was an effective quality monitoring system that demonstrated that the provider listened to the comments made by people and relevant actions were taken to improve the service.