Archived: Wolds & Coast Domiciliary Agency

Wolds & Coast Domiciliary Agency provides personal care to people living in their own home.

Not everyone who used the service received personal care. CQC only inspects where people receive 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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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

People and their relatives told us they were happy with the service provided. Staff understood the importance of providing person-centred care and had developed positive relationships with people which helped to promote their independence. People told us, and our observations confirmed staff were kind and caring. People were respected, staff championed their privacy and dignity and encouraged their independence in all aspects of life.

People continued to receive a good service. They were safe from harm. Systems and processes supported this. People’s risks were safely managed. Sufficient numbers of safely recruited staff were employed to support people providing consistency of care. People were safely supported with handling medicines and keeping their homes clean.

Staff received appropriate support and training to carry out their roles. This included regular supervision and appraisal.

The provider was responsive to feedback and completed a range of checks to assure quality. Feedback, along with action plans resulted in managed improvement where this was required.

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

Rating at last inspection.

The last rating for this service was Good (published 21 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wolds & Coast Domiciliary Agency on our website at www.cqc.org.uk.

Follow up

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

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 support workers who knew about people’s needs and preferences. People were involved in aspects of their care and were asked for their consent before support workers undertook care and support tasks. People’s wellbeing, privacy, dignity and independence were monitored and respected and support workers worked hard to maintain these wherever possible. People were supported according to their support plans, which were regularly reviewed and amended according to need and/or requests. People were supported with nutrition and hydration where necessary.

There was an effective complaints procedure in place and people had complaints investigated without bias. People that used the service, relatives and their friends were encouraged to maintain healthy relationships.

We saw that the service was well-led in all aspects. People had the benefit of an open and inclusive culture and the management style of the service was positive. There was an effective system in place for checking the quality of the service using audits, satisfaction surveys, meetings and good communication. Information from the quality monitoring and assurance system had been used to take action and make changes to the service for people but this had not been fed back to anyone who used the service or other stakeholders. We made a recommendation with regard to this.

People were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in the company offices.

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.