Background to this inspection
Updated
25 March 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was undertaken by 1 inspector.
Service and service type
This service provides care and support to people living in their own home, 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We received information of concern about the service which the provider sent us and which triggered this inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with 2 people and a relative about their experience of the service. We spoke with the interim operations manager, operations manager, acting manager and 2 care staff.
We reviewed a range of records including 2 care plans and medication records. We looked at 1 staff file in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. During the inspection, we requested and received additional information from the interim operations manager by email.
Updated
25 March 2023
About the service
Living Options Outreach – Domiciliary Care can provide personal care and support for up to 3 people with a range of disabilities. At the time of our inspection there were 2 people using the service. Both people received personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
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.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support: People were not always supported to have maximum choice and control of their lives. People chose how they wanted to spend their days and were supported by staff to follow their interests. However, if staff were not available, people could not always go out when they wanted, even though they were allocated additional funding for one-to-one support.
Right Care: Care was personalised to meet people’s needs. People were cared for by staff who knew them well. People's preferences, likes and dislikes had been documented in their care plans which staff followed.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using services were able to lead confident, inclusive and empowered lives. Lack of oversight at the service had resulted in people being harmed. Concerns raised were not always listened to or acted upon by the provider.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (report published 11 May 2019).
Why we inspected
The inspection was prompted in part by notification of incidents of alleged abuse affecting people who used the service. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incidents. However, the information shared with CQC about the incidents indicated potential concerns about the management of risks. This inspection examined those risks.
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 has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the well led section of this report. You can see what action we have asked the provider to take at the end of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Living Options Outreach – Domiciliary Care on our website at www.cqc.org.uk.
Enforcement
We have identified a breach in relation to the governance and management oversight of the service. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.