About the service:

Head Office (Omega Homes) is a domiciliary care agency and supported living service. It provides personal care to younger adults with learning disabilities, and physical disabilities living in their own houses which were supported living environments. People needed help with day-to-day tasks like cooking, shopping, washing and dressing and help to maintain their health and wellbeing. People had a variety of complex needs including mental and physical health needs.

Head Office (Omega Homes) provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. 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 two supported living properties in the Longfield and Gravesend area of Kent. In these premises people each had their own bedrooms, but shared the kitchen, dining room, lounge, laundry and the garden. There was an office at each site.

Not everyone using Head Office (Omega Homes) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The service was providing personal care to six people diagnosed with learning disabilities and autistic spectrum disorder at the time of the inspection.

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’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; staff recognised that people had the capacity to make day to day choices and supported them to do so. People were encouraged to be independent. People were engaging in the community.

Risks to people’s safety had not always been identified. Risk assessments did not have all the information staff needed to keep people safe. The provider had not always reported and arranged repairs with the landlord and maintenance had not always been undertaken in a timely manner.

Medicines were not always managed safely. Medicine administration records (MARS) were not always complete and accurate and did not always show that people received their medicines as prescribed. Where people had ‘as and when’ medicine such as pain relief there was information for staff such as how often the medicines could be taken and when it may be needed. Medicines were stored safely.

People were not always supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service did not always support this practice. Some people’s care files showed consent forms which relatives had signed. There were no capacity assessments in place to evidence that the person had been asked about the decision. There were no records that best interest meetings had taken place with relevant people to discuss what would be in people’s best interests.

The provider had not always made adequate records when recruiting staff to demonstrate that they had carried out thorough pre-employment checks. This is an area for improvement. There were suitable numbers of staff on shift to meet people’s needs.

Accidents and incidents had appropriately been recorded and reported and actions had been taken. The accident and incident forms had not always been updated by a member of the management te

The inspection was carried out on 16 August 2016, and was an announced inspection. The provider was given short notice of the inspection as we needed to be sure that the office was open and staff would be available to speak with us.

Omega Homes is a domiciliary care agency which provides supported living service to younger adults. Care was delivered to younger adults with learning disabilities, and physical disabilities. People needed help with day-to-day tasks like cooking, shopping, washing and dressing and help to maintain their health and wellbeing. People had a variety of complex needs including mental and physical health needs. At the time of the inspection, the service was providing support to four people who lived in the same house. The service was currently operated from the premises where the four people lived.

There was a registered manager employed at the service. 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.

The registered manager and staff had received training about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) and understood when and how to support peoples best interest if they lacked capacity to make certain decisions about their care. Staff understood the processes to follow if they felt a person’s normal freedoms and rights were being significantly restricted.

People were protected against the risk of abuse. Staff had had training and recognised the signs of abuse or neglect and what to look out for. Management and staff understood their role and responsibilities to report any concerns and were confident in doing so. Staff told us they knew what to do if they needed to whistle blow, and there was a whistleblowing policy available.

People had varied needs and the people living in the service had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy for example, by facial expressions, a smile to the registered manager, and staff who were supporting them. Staff were attentive and interacted with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for help.

There were enough staff with the skills required to meet people’s needs. Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments had been updated and were individual for each person. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice, such as doctors, speech and language therapist (SALT) and dieticians.

People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.

People could easily access food and drink and snacks during the day. People were involved in shopping. Staff knew people that lived in the service well and were engaged in meaningful and fun conversations with people. Staff encouraged people to be as independent as possible.

Interactions between people and staff were positive and caring. People responded wel