Cavendish Domiciliary Care Agency is a supported living service. They provide support to people living at 7 houses. They provide support for people with autism and learning disabilities. Some people had diagnosed mental health conditions. At the time of our inspection, there were 31 people receiving personal care.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good

Risks to people were assessed with appropriate plans in place to keep them safe. Where incidents occurred, actions were taken to prevent them from reoccurring. People’s medicines were administered safely by trained staff. Staff understood their role in safeguarding people from abuse. The provider carried out appropriate checks to ensure staff were of good character. Staff were deployed in a way that meant people’s needs could be met safely.

People were supported by staff who were trained to carry out their roles. Staff worked in accordance with the Mental Capacity Act 2005, this meant that people’s legal rights were protected. People were supported to prepare food in line with their dietary requirements and preferences. Staff worked alongside healthcare professionals to meet people’s needs.

People were supported with kindness and compassion by staff that knew them well. People were involved in their care and their independence was encouraged. Staff were respectful and promoted people’s privacy and dignity.

Care plans were person centred and reflected people’s individual personalities and interests. People had access to a range of activities that they enjoyed. People were supported to complain if they wished to. Any complaints were responded to appropriately.

Measures were in place to involve people and staff in the running of the service. The provider took staff wellbeing seriously. Regular checks were undertaken to monitor the quality of the care that people received. The provider kept up to date records that were easy to access.

Further information is in the detailed findings below.

Cavendish Domiciliary Care Agency (CDCA) provides support to individuals in their own home. The service supports people with a learning disability and some people may also have a physical disability. At the time of our inspection CDCA were supporting 26 people living in seven supported living houses.

The service is registered for the provision of personal care in people’s own homes. This includes assistance and prompting with washing, personal care and dressing, eating and drinking. We call this type of service a supported living service.

People’s accommodation was provided by a separate landlord usually on a rental or lease arrangement. CDCA was solely responsible for the provision of personal care to people and not for the property. This meant people could use an alternative service provider if they wished.

People who use the service had a wide range of and support needs, ranging from mild to severe learning disabilities. Some people may have needed support 24 hrs. of the day. Other people were more independent and receive support for a few hours a day to help with their daily routines.

This was an announced inspection which took place on 14 April 2016.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People felt safe and staff knew what actions to take to protect people from abuse. Staff recorded assessments to identify people’s health and support needs and any risks to people. There were processes in place to identify, manage and reduce risks to people.

People were supported by enough suitably qualified and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken to ensure the staff were suitable for their role.

People received care from a consistent staff team who were well supported and trained in meeting people’s needs.

The provider had systems in place to support people take their prescribed medicines safely.

People were provided with a choice of healthy food and drink to make sure their nutritional needs were met. At mealtimes people ate well and were content with their choices.

Care staff understood the need for consent when providing care.

People were supported in a way that promoted their dignity by being valued and spoken to kindly and treated with respect.

Staff supported people to maintain good health and access healthcare professionals when needed.

Assessments had been carried out and personalised care plans were in place which reflected each individual’s needs and preferences.

The provider has an effective complaints procedure and people had confidence that concerns would be investigated and have been addressed.

The registered manager had developed innovative systems to seek people’s views about their care on a daily basis. People received care that was consistently responsive to their needs.

The service benefited from an open management structure and visible leadership. Arrangements were in place to monitor the quality of the service being delivered and drive improvement.

We carried out an inspection at Cavendish Domiciliary Care Agency to look at the care and support that people who used the service received. As part of our inspection we also visited some people in their homes and spoke with people's relatives. We also spoke with staff about their role and responsibilities.

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?

Is the service safe?

We saw that people who used the service had been involved in the planning of their care and their choices and wishes were respected. For example, we saw that people attended their chosen activities regularly.

There were enough suitably skilled staff to safely support people. Staff we spoke with said "We all work well as a team to make sure people receive the care and support they should have".

People told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Is the service effective?

People's health and care needs were assessed with them and they or their representatives were involved in the compilation of their care plans. People said that they had been involved in the planning of their care. Staff we spoke with demonstrated they had a good understanding of people's needs and this mirrored the information included in their care plans.

The people who used the service told us that they were "Happy" with the care and support provided. One person said "I'm very happy." Another person's relative said "My family member is a different person, they have come on leaps and bounds".

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people.

People's relatives told us that staff were "Wonderful" and "Very caring".

People's preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw that people's plan of care had been reviewed regularly and updated when their care and support needs had changed.

Staff were attentive and supported people quickly when they needed assistance.

Is the service well-led?

Staff we spoke with were clear about their roles and responsibilities. They told us that they worked "Well" together as a team and were "Supported" by the manager.

The home managers spoke with people on a daily basis to gain their views and suggestions for improvement regarding the care and support they received.

We were told about a new project in the organisation called 'Project Acorn'. This had been developed, with the involvement of staff, to help drive improvement throughout the service. Staff demonstrated enthusiasm for this project.

Most people who used the service had complex needs, which meant they were not able to tell us their experiences of using the service. Therefore, we used our observations, spoke with relatives of people and spoke with one person who was able to express some of their views.

One person said they liked the staff. They told us that they had recently visited a theme park and had enjoyed the day out. Relatives of people we spoke with told us they felt the service provided a high quality of care. One person said "I wouldn't leave my relative if I didn't feel they were happy and safe".

Relatives also told us that staff encouraged people to make their own choices and that they had been kept fully up to date with regards to the care provided. However, we found concerns that where people did not have capacity, the provider did not act in accordance with legal requirements.

People we spoke with and their relatives said they felt "Safe" with staff. They told us that the service sought regular feedback and if they had any concerns then they would speak with the Registered Manager and felt confident that the appropriate action would be taken. However, we found that the service had not always followed the correct procedures with regards to reporting concerns to the appropriate authority for investigation.

We found that people were safely supported with their medications.

Staff told us they received good training opportunities and felt "Supported" by the service.

As part of our inspection we spoke with three people who used the service and their relatives about the care and support they received. We also spoke to the Registered Manager and four support staff. During the inspection we saw people visiting the office and noted that the interactions were positive and people were at ease with staff.

People told us they were happy with the care provided by Cavendish Domiciliary Care agency. Comments included "I like it here and all of the staff are nice" and "I have a nice room where I can watch what I want on TV".

We were told that staff respected the privacy and dignity of people by knocking on doors and speaking appropriately to them. People told us that the staff were "Good" and that they were able to speak to them about how they felt.

People told us they were involved in their care and support. One person said "The communication is marvellous" and "We have regular meetings with the manager".

Relatives of people told us they are happy with the service and felt that people are safe. They told us that if they had a problem or concern they knew who to speak to about it. Comments included "They make sure people are safe" and "I've only ever had one concern and it was dealt with immediately".