About the service:

Mencap Derbyshire and Derby City Domiciliary Care Agency is a domiciliary care agency that provides personal care to adults with a learning disability living in their own homes. Some people lived alone and others with other people that were also receiving a service from Mencap Derbyshire and Derby City Domiciliary Care Agency. Some people received support from staff at various times of the day and others over a full 24-hour period. Not everyone using the service received a 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. At the time of the inspection 24 people were provided with the regulated activity of personal care.

People’s experience of using this service:

The service met the characteristics of ‘Good’. Staff understood their responsibilities to safeguard people and report any concerns. People received support to take their medicines safely. Recruitment checks determined the suitability of new staff to protect people that used the service. The risk of people acquiring an infection, was minimised as infection control procedures were in place and followed. Support plans were in place to promote positive behaviours and safeguard people from injury when they became anxious.

People received the support they needed as sufficient staff were available to support them to do what they wanted to do. The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; People were supported to take reasonable risks which enabled them with opportunities to lead a full life. People spent their day as they preferred and were supported to take part in social activities of their choice to enhance their well-being.

Staff understood the support people needed to make decisions when they were unable to make specific decisions independently. Mental capacity assessments and best interest decisions were undertaken where people needed support to make specific decisions. This demonstrated that people’s rights were upheld and they were supported in the least restrictive way possible.

People were supported as needed, to ensure their preferences and dietary needs were met. Healthcare services were accessible to people with staff support as needed, and people received coordinated support, to ensure their preferences and needs were met.

Information was available in an accessible format to support people’s understanding. People maintained relationships with their family and friends and were encouraged to give their views about the service. This included raising any concerns they had. People and their representatives were involved in their care to enable them to receive support in their preferred way.

There were systems in place to monitor the quality of the service and these were used effectively to enable the provider and registered manager to drive improvement.

Rating at last inspection: Good (report published 11/01/2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we found the service remained Good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

We inspected this service on 28 July 2016 and the inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived. At our last inspection in August 2013 there were no breaches in the regulations we looked at. There were 23 people in receipt of personal care support at the time of this inspection visit.

There was 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. The registered manager oversaw the running of the full service and was supported by three service managers who were allocated a geographical area to manage. Service managers were responsible for individual parts of the service, for example support to people in a supported living unit or support to people living with their family or alone.

Sufficient staff were available to meet people's needs and people received calls from a consistent group of staff. Staff had knowledge about the support people needed to enable it to be provided in a safe way. Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. The provider had undertaken thorough recruitment checks to ensure the staff employed were suitable to support people. Medicines were managed safely and people were supported to take their medicine when needed. Following risk assessments equipment was in place to meet people’s diverse needs which enabled them to maintain choice and independence.

Staff were provided with training to support the people they worked with and they received supervision, to support and develop their skills. Staff knew about people’s individual capacity to make decisions and understood how to support people to make their own decisions. When people were unable to consent mental capacity assessment and best interest decisions had been completed.

People’s needs were assessed and support plans where developed with people and directed staff on how to support them in their preferred way. People were supported to maintain a diet that met their dietary requirements and preferences and were supported to access healthcare services.

The delivery of care was tailored to meet people’s individual needs and preferences. People were enabled to develop and maintain hobbies and interests within the local community to promote equality and integration.

There were processes in place for people to express their views and opinions about the service provided and to raise any concerns they had. The provider had systems in place to monitor the quality of the service to enable them to drive improvements.

We found that this service worked well with other professional disciplines to provide personalised care packages to each person.

Records showed that people using the service were involved in the development and on-going review of their care package. Some people were able to confirm that they were involved in regular reviews and discussion about their care.

Thirty four people were using the service at the time of our visit; some people did not need any support with personal care needs but were supported with budgeting and shopping. We spoke with six of the people using the service. All of the people we spoke with confirmed that they were happy with the support and services provided to them by staff. People confirmed that there were no issues with staff turning up to support them.

People told us that they knew who they could talk to if they had any concerns or complaints. People that did not have 24 hour support confirmed that they had a contact number to call, for support in an emergency situation.

Recruitment records demonstrated that thorough recruitment checks were undertaken before staff commenced employment, this ensured that the provider and registered manager had assured themselves that the staff employed, were considered safe to work with the people using the service.

Systems were in place to monitor the support and services provided, and to identify and manage risks to ensure the service was run safely.

We spoke with four of the people using the service. All of the people we spoke to confirmed that they were happy with the support and services provided to them by staff. People confirmed that there were no issues with staff turning up to support them.

People told us they had copies of their support plans in their homes.

They confirmed that they were involved in regular reviews and discussion about their care. Information in people’s support records demonstrated this.

People told us how staff supported them to pursue interests and make decisions about their life. Information in the people’s support records demonstrated this.

People told us that they felt safe and that they knew who they could talk to if they had any concerns or complaints.

Staff were provided with training updates as required in all mandatory areas of training. Training was also provided to staff regarding individuals specific needs, such as managing behaviours that challenge, and supporting people with epilepsy, autism and downs syndrome. This ensured staff were kept up to date with current practice.

Staff supervision was provided on a regular basis, to ensure staff were supported to maintain and develop their skills.

Systems were in place to monitor the support and services provided, and to identify and manage risks to ensure the service was run safely.

People we spoke to told us that they were happy with the support they received from the agency. They told us that the service is reliable and that staff are supportive and caring.