The Field Lane Domiciliary Agency - Southend-on-Sea

The Field Lane Domiciliary Agency Southend-on-Sea is registered to provide personal care. The people using this service are living with various types of learning disabilities. They are supported by the agency to live as independently as possible in a supported housing environment. The agency is currently supporting people living in two separate premises in the Southend area. Both houses are staffed 24 hours a day.

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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

Right Care:

People were cared for and supported by staff who had received the appropriate training.

There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medication was dispensed by staff who had received training to do so.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for people.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care.

Right Culture:

The provider had processes in place to check staff were safely recruited; however, not all relevant information was documented for new applicants.

We have made a recommendation about the provider’s recruitment processes.

The registered manager responded to complaints received in a timely manner. People were supported to make plans for the end of their life. However, these were not fully documented.

We have made a recommendation for people to have detailed end of life care plans in place.

People and their relatives and advocates were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities.

The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection

The last rating for this service was Good (last report published 02 August 2019).

Why we inspected

We received concerns in relation to people unable to make choices about the activities they took part in and people not being encouraged to live an independent life. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service is good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Field Lane Domiciliary Agency – Southend-On-Sea on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Field Lane Domiciliary Agency Southend-on-Sea is registered to provide personal care. The people using this service are living with various types of learning disabilities. They are supported by the agency to live as independently as possible in a supported housing environment. The agency is currently supporting people living in two separate premises in the Southend area. Both houses are staffed 24 hours a day.

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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Medication was dispensed by staff who had received training to do so.

People were cared for and supported by staff who had received the appropriate training.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for people.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

People and their relatives and advocates were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities. The manager responded to complaints received in a timely manner. People were supported to make plans for the end of their life.

The manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection

The last rating for this service was Good (last report published 10 November 2016).

Why we inspected

This was a comprehensive inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Field Lane Domiciliary Agency – Southend-On-Sea on our website at www.cqc.org.uk.

The Field Lane Domiciliary Agency Southend-on-Sea is registered to provide personal care. The people using this service are living with various types of learning disabilities. They are supported by the agency to live as independently as possible in a supported housing environment. The agency is currently supporting people living in two separate premises in the Southend area. Both houses are staffed 24 hours a day.

The service has 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely; they received opportunities for training and supervision. People were safeguarded from harm. Staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS) and how to apply these. The registered manager was aware of how and when to make a referral. People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met.

People were provided with the opportunity to participate and engage in activities of their choice which met their needs. Relatives and people who used the service knew how to make a complaint and we felt reassured that all complaints would be dealt with and resolved efficiently and in a timely manner.

The service had a number of ways of gathering people’s views which included holding meetings with people, staff, and relatives. The registered manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to help them make any improvements.

Staff we spoke with said they had been properly recruited and trained. Staff told us that they received very good support in their roles.

We saw that people's care and support was planned and reviewed regularly. Risks to the health, welfare and safety of the person were identified and managed.

Some of the people we met at our inspection could not, because of their disabilities, tell us verbally about their experiences and so we used observation to help us understand their experience of the service. People we were able to speak with told us that they were satisfied with how they were treated and with the level of support provided. One person told us, "The staff are good to me and I'm looked after.' 'I like it here the staff ask me if I feel safe.' Another person said, 'I like this house the staff are really nice people, they have completely changed things for the better for me.' 'I appreciate the staff and the manager is the best.'