This inspection took place on the 30 January 2018 and 23 February 2018 which was unannounced, the inspection team consisted of one inspector.

Brook Drive is a small domiciliary care agency that provides 24 hour support and personal care to people who live in their own homes in Wickford, Essex. The service has three bungalows which are owned by the provider and rented out to people using the service. These bungalows have been adapted to each individual’s needs. People supported by the service may have a learning disability or multiple/complex needs. At the time of our inspection there were three people using the service.

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.

The service was safe. The service’s recruitment process ensured that appropriate checks were carried out before staff commenced employment. There were sufficient staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to their health. People’s medicines were managed well and records of administration were kept up to date.

The service was effective. People were cared for and supported by staff who had received training to support people and to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner and had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. Records we viewed showed people and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was well-led. Staff and people spoke very highly of the registered manager and the provider who they said were very supportive and worked hard to provide an exceptional service. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis.

The inspection took place on the 07 September 2015.

Brook Drive is a small domiciliary care agency. It provides 24 hour support and personal care to people who live in their own homes. People supported by the service may have a learning disability or multiple/complex needs.

The service had a registered manager in post. 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.

People were treated with dignity and respect and staff interacted with people in a kind, caring and sensitive manner. Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people.

There was a regular and consistent staff team, which meant people received care from people they knew. The provider had appropriate recruitment checks in place which helped to protect people and ensure staff were suitable to work at the service. There were sufficient numbers of skilled, well trained and qualified staff on duty and staff told us that they felt supported in their role. We saw that staff had received training and had regular support.

We found that detailed assessments had been carried out and that the care plans were very well developed around each individual’s needs and preferences. There were risk assessments in place and plans on how the risks were to be managed. We saw that appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves; to help ensure their rights were protected. People were supported with taking every day risks and encouraged to take part in daily activities and outings.

People were seen to be happy and relaxed with staff. Systems were in place for people to raise concerns and they could be confident they would be listened to and appropriate action would be taken.

People’s medication was well managed and this helped to ensure that people received their medication safely. They were supported to be able to eat and drink sufficient amounts to meet their needs and were offered choice. We found that people’s healthcare was good. People had access to a range of healthcare providers such as their GP, dentists, chiropodists and opticians.

The provider had an effective quality assurance systems in place. People had the opportunity to feedback on their experiences and staff tried to involve people in day to day decisions and the running of the service. The service was well managed.

The service is small and provided a bespoke service to four people. We looked at two of the four people's care records. From our observations the service employed sufficient care workers and all had received regular training and support. The service does not have a registered manager at present, but the acting manager assisted with the inspection visit and it is their intention to apply for registration.

Three staff were spoken with to gain their views about the service; where possible their feedback has been incorporated into this report. The four people who received a service were asked if they would like to speak to an inspector, but they all declined. Two relatives were contacted to gain their views on the service.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

Relatives spoken with confirmed that their relatives were treated with respect and dignity by the care workers and added that they felt their relatives were safe. Safeguarding procedures were in place and care workers spoken with understood how to safeguard the people they supported.

Care workers had been provided with training in safeguarding vulnerable adults from abuse. This meant that staff had been provided with the information they needed to ensure that people were safeguarded. The manager had also completed training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), so was aware when to make referrals to ensure people were kept safe.

The service had sufficient care workers to provide the care and support needed. Those people spoken with stated that their relatives had regular carer workers who provided support. One relative added that they felt this had helped them to become more relaxed and their relative was “More happy” since receiving a service. They were confident that their relatives received the care required.

Is the service effective?

People's care records showed that care and treatment had been planned and delivered in a way that ensured people's safety and welfare. The records had been regularly reviewed and updated, which meant that care workers had been provided with up to date information about how people's needs were to be met. People received effective care and support and family members told us that they had seen an improvement in the dependency levels of their relatives since receiving a service.

Is the service caring?

People were supported by kind and attentive staff. Family members spoken with provided positive comments about the care and support their relative received and confirmed they were offered choice and had been included in any decisions made. People’s diversity, preferences, interests and aspirations had been recorded and care and support had been provided in accordance with people’s wishes. Care workers spoken with had a good understanding of people’s care needs and how they wished to be supported.

Is the service responsive?

People who used the service were supported in participating in activities and daily life skills, and their choices were taken in to account and they were listened to.

People knew how to make a complaint if they were not happy, although some stated that it was sometimes difficult to contact the service on the phone. One person told us that they were confident their concerns would be listened to and acted upon, whilst another stated they would use their relative’s social worker for concerns to be raised.

Is the service well-led?

The service does not presently have a manager that is registered with the Care Quality Commission. The acting manager is in the process of preparing their forms for submission.

The service worked well with other agencies and services to make sure people received continuity of care. There were clear lines of accountability and systems in place for people to raise any concerns they may have had.

Due to the service only been up and running for less than a year, people who used the service and their relatives had not yet had the opportunity to complete satisfaction questionnaires. Management were presently looking at ways to gain feedback about their service and a pictorial questionnaire had been developed. Management advised that were concerns or short falls are identified they will organise and action plan for these to be addressed.

The service had some quality assurance systems in place, but as it was a new service the management were still in the process of developing these.

Care workers stated that they had found the service well led. They added that the management were very approachable and supportive. They all added that they found the work ‘rewarding’ and could always speak to someone if they needed advice or support.