The inspection of Wolds & Coast Domiciliary Care Agency (DCA) took place on 04 and 09 November 2016 and was initially unannounced, because the inspection began as a Focussed inspection on 04 November 2016. This became a Comprehensive Rated inspection and was completed as an announced inspection on 09 November 2016. We visited the agency offices and visited five people who used the service. This was to obtain people’s views of the care and support they received.

At the last inspection in August 2015 the service met all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and was rated as a ‘Good’ service. At this inspection in November 2016 we also found the overall rating for this service to be 'Good' as there had been no changes in the quality of the service since the last inspection. The rating is based on an aggregation of the ratings awarded for all five key questions.

The service provides support to 35 people in their own homes, who may be living with dementia, have a learning disability and/or autistic spectrum disorder, a physical disability or a sensory impairment. People mainly live in shared houses and have individual tenancy agreements with East Yorkshire Housing Association. The support provided to people can be with personal care, food provision, personal safety, social activity and/or financial needs.

The registered provider was required to have a registered manager in post. On the day of the inspection there was a manager who had been the registered manager for the last five years. 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 2008 and associated Regulations about how the service is run.

The registered manager explained to us that the agency was owned by East Yorkshire Housing Association Limited and run as a separate concern to the ‘housing arm’, which had charity status.

People were protected from the risk of harm because the registered provider had systems in place to manage safeguarding incidents. Support workers were trained in safeguarding adults from abuse and understood their responsibilities in respect of managing safeguarding concerns. Risks were managed and reduced on an individual basis so that people avoided injury or harm.

Staffing numbers were sufficient to meet people’s needs and we saw that rosters accurately cross referenced with the support workers on duty. However, the registered provider had been recruiting new staff for some time and this was proving difficult. Incentives had been introduced to attract new candidates to the vacancies. Recruitment policies, procedures and practices were followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of people’s medicines was safely carried out.

People were cared for and supported by qualified and competent support workers. Support workers were supervised and took part in an appraisal scheme regarding their personal performance, although we found that these schemes had been neglected on several occasion over the last year. This had not been identified quickly enough to prevent the lack of regular supervision having an effect on support to workers. We made a recommendation about this.

Communication was satisfactory and both people and support workers felt information was appropriately shared in good time. People’s mental capacity was appropriately assessed and their rights were protected with regard to ensuring their liberty. Support workers had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they encouraged people to make decisions for themselves.

We found that people received appropriate care from kind supp

The inspection of Wolds & Coast Domiciliary Agency was on 05 August 2015 and was unannounced. At the previous inspection on 05 December 2013 the regulations we assessed were all being complied with.

Wolds & Coast Domiciliary Agency provides home based support to people with a learning disability. Support is provided to people living within shared tenancies in Bridlington. At the time of our inspection the service had 26 people that used the agency.

The registered provider is required to have a registered manager in post and on the day of the inspection 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. There was also a recently appointed manager who was beginning the process of applying to become the registered manager. This was because the registered manager was carrying out a more regional managerial role and the organisation had decided to take on another manager entirely for the service.

People were protected from the risks of harm or abuse because the registered provider had systems in place to manage suspected or actual safeguarding concerns and support workers and other employees were appropriately trained in and knowledgeable about safeguarding adults. We saw from documentation that all incidents were addressed, investigated and learned from.

We found that people were protected from harm by following robust risk assessments for their safety, there were sufficient support workers employed to meet their needs and support workers were carefully vetted to ensure they were suitable to work with vulnerable people. Where people required medication those that needed support with it were appropriately supported to take it by trained and knowledgeable support workers, so that people took their medication safely.

The staffing complement were appropriately trained and skilled to carry out their roles, they understood the principles and legislation of the Mental Capacity Act and the Deprivation of Liberty Safeguards and they encouraged people to make their own choices and decisions about daily living. Safeguards based on current legislation were in place and the legislation was used to ensure people’s rights were upheld. We found that people were supported with healthy nutrition and their general health care needs were carefully monitored to ensure they ate well and maintained optimum health.

We found that people were treated kindly by support workers from the agency. Workers were professional but friendly and encouraged people to be as self-determining and independent as possible. People told us that support workers ensured they felt involved in their care and support because they were consulted about all things that related to them. Support workers had an understanding of the importance of encouraging people to have good wellbeing and to engage in activities and pastimes in the community.

The agency was responsive to people’s needs because support workers followed person-centred support plans, encouraged people to engage in occupation and activities of their choosing and listened to people when they had problems or expressed dissatisfaction.

We found there was a healthy culture within the agency where support workers worked as a team to create a friendly atmosphere for people that lived in their shared tenancies and used the agency. The management style was tolerant, freethinking and non-interventionist and it enabled all employees of the agency to take on their roles within an environment that was non-restrictive and so people were able to lead individual lifestyles while being well supported. Everyone’s opinion was valid and considered as relevant and this meant people felt valued and cared for.

There were systems in place to monitor and assess the quality of service delivery, but these required further development to ensure audits were more extensive and analysis of the information gathered was transferred into an action plan for improvement and carried out. Any changes made needed to be fed back to people that had contributed to the surveys and audits. We have made a recommendation to the registered provider regarding these issues.

At the time of our visit Wolds and Coast Domiciliary Agency was providing support to 27 people residing in eight shared tenancy houses.

People’s consent was obtained before care and support was provided. Where people did not have capacity to consent to care or treatment best interest decisions were made that involved the relevant people involved in the person’s care.

Care plans provided clear guidance to support staff to ensure people’s needs were safely met. People we spoke with confirmed they were satisfied with their support.

People were supported to take their prescribed medication in accordance with their care plan.

Appropriate recruitment policies were in place to check that people working at the service did not present a risk to people who lived at the service.

The provider had effective systems in place to check on the quality and safety of the service people received.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from Wolds and Coast as part of a targeted inspection programme of domiciliary care agencies, with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector.

We used postal surveys, telephone interviews and home visits to people who use the service and to their main carers (a relative or friend) to gain views about the service. We contacted twelve people as part of this inspection, including three people who we visited in their own home.

The four people that we spoke with said that staff used their preferred name.

Two people that we spoke with told us that they could shower themselves but that staff made sure that assistance with personal care was done in private. One person said in a survey, “The care workers take me out weekly and give me choice of meals and help and support me buy other things that I may need.”

People told us that they were satisfied with the support they received from care workers and from the agency. Their comments in surveys included, “The service I receive is very good and I am happy”, “The care workers are kind to me and treat me well” and “The care workers always help me. We have fun. I love living here.”

The people that we spoke with were able to name someone that they could speak to if they had any concerns. They told us that support workers managed their money safely and in a way that protected them from the risk of financial abuse.

The people that we visited at their home said that the care workers were good and supported them in the right way. One person said, “The care workers are good to me and x. They can’t do enough for us.”