Royal Mencap Society – Lincolnshire Domiciliary Care Agency provides personal care and support for people in their own homes who have a learning disability or autistic spectrum disorder. The service can provide care for adults of all ages. At the time of our inspection the service was providing support for 60 people most of whom were younger adults. About one half of these people lived in properties that they shared with other people who also received assistance from the service. In this report we refer to the shared properties as being, ‘shared homes’. Most of the remaining people lived in properties for which they were the sole tenants. We refer to these sole tenancies as being, ‘private homes’. The service covered north Lincolnshire including Boston, Skegness, Market Rasen, Lincoln and Gainsborough.

There was a registered manager. 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People had been supported to promote their wellbeing, to reduce the risk of accidents and to safely manage medicines. There were enough staff to support people who lived in the shared homes and to visit people in their private homes. Background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to support people in the right way. This included being able to assist people to eat and drink enough in order to stay well. In addition, people had been supported to receive all of the healthcare assistance they needed.

The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had received all of the support they needed including people who had special communication needs or who could become distressed. People had been consulted about the support they wanted to receive and they had been given all of the assistance they needed. Staff had supported people to express their individuality including pursuing their interests and hobbies. There was a system for resolving complaints.

Regular quality checks had been completed to ensure that people received all of the support they needed and people had been consulted about the development of the service. Staff were supported to speak out if they had any concerns because the service was run in an open and relaxed way. People had benefited from staff receiving and acting upon good practice guidance.

There were systems in place to make sure that any person who used the service had their right to make decisions about their support and care valued and respected. People who used the service and family members of other people, who used the service, were actively consulted in decision making processes.

People who used the service and family members of other people who used the service had positive comments to make about the standard and quality of the support and care provided. Support and care provided maintained and promoted people’s health and wellbeing.

Systems were in place to safely and appropriately support people with equipment that they needed to maintain their independence, health, safety and comfort needs.

There were sufficient numbers of trained and skilled members of staff to provide people who used the service with safe and appropriate support and care to meet their individual needs.

There were systems in place which provided any person who used the service, or their representative, with opportunities to share their views and suggestions with the agency. Other quality assurance systems were in place to protect people from unsafe and inappropriate support and care.

We did not speak with people who use the service. We visited the Bourne Mencap office. The Bourne office coordinates the personal care service for locations in Boston, Spalding and Bourne.

We saw people had been involved in appointing support staff to work in their home. We read comments people made about a prospective candidate. One person said, “Good to talk to. Would like him to work here.” Another person said, “Liked him a lot.”

People had risk assessments specific to their individual need. People were supported to maintain their independence and learn new skills.

The staff we spoke with told us how to identify signs of abuse. Staff told us how they would report safeguarding concerns within their organisation.

Staff told us each house held separate tenants meetings. People who lived in the house discussed matters which were important to them. One member of staff told us, “One group wanted permission to decorate their house. We supported them to contact the landlady and they gave them permission.”