Chorley Domiciliary Service

About the service

Chorley Domiciliary Service supports people who have a learning disability in their own home and provides personal care in line with a 'supported living' model. Supported living is a way of supporting people in their own home with their personal care or support arranged separately with a specialist provider.

Everyone supported by Chorley Domiciliary Service had their own tenancy agreement. At the time of the inspection 36 people were receiving support from the service.

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

Right Support

We found medicines were not always managed safely. Records related to medicines administration were not always accurate. The service is planning to introduce a more robust system to address the concerns.

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

Staff thoroughly assessed people’s needs and developed plans of support which enabled them to make choices and promoted positive risk taking. People’s homes were personalised, and we could see people’s choices about décor and furniture were respected. Staff had received training to keep people safe and knew what action to take in response to any allegations of abuse.

Right Care

The service provided care that was centred around the person, their needs and their wishes. Staff knew people well and information was available to guide staff on how best to support people. Staff had received training to ensure they could meet people’s needs effectively. The service followed government guidelines to reduce risks related to infections.

Right Culture

The provider had various methods to assess, monitor and improve the quality of the service, however, these had not identified and addressed the issues we found with medicines management. We have made a recommendation about this. People chose how they spent their time and their decisions were respected. Staff told us they felt well-supported and could raise concerns with the management team. We observed people were comfortable and relaxed in the presence of staff and in each of the tenancies we visited, there was a homely and cheerful atmosphere. Staff worked well with external agencies to ensure people’s needs were met.

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 6 November 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can see what action we have asked the provider to take at the end of this full report.

The provider acted to make improvements to ensure people were not at risk of harm from concerns around medicines management.

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 safe section of this full report.

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

Enforcement and Recommendations

We have identified a breach in relation to medicines management at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service is registered to support older people, people living with dementia, learning disabilities or autistic spectrum disorder, mental health needs, physical disability and younger adults.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There continues to be a registered manager in post who is supported by seven team managers. People and staff spoke positively about the management team of the service.

Risks to people were assessed and action taken to reduce them. Staff were able to explain different types of abuse and were aware of action they should take if they had any concerns. A safeguarding referral had been made appropriately.

There were safe systems in place to support people with their medicines.

Appropriate recruitment checks were undertaken before staff started their employment, to ensure they were suitable to work with vulnerable people.

There was a large staff team in place and a system was in place to ensure a person is supported by a consistent staff team.

Staff received induction, training and supervision to give them the skills and knowledge they needed to care for people effectively. From the start of employment all staff work towards achieving the Care Certificate and then are encouraged to pursue further development opportunities.

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 supported this practice.

People received support with their nutritional needs where required and people were satisfied with the support they received to shop and prepare meals.

Staff sought advice from healthcare professionals when they had any concerns about people's health.

Staff treated people with dignity and respect and supported people to maintain their independence. We observed caring interactions between staff and people who used the service. It was evident staff knew people well and that meaningful relationships had developed. There was a positive, person-centred culture within the service.

Care plans were in place to give staff the information they needed to support people in line with their preferences and needs.

The provider had a policy for responding to any concerns and complaints. People told us they would feel comfortable reporting any concerns and were confident these would be addressed.

There was a quality assurance system in place to monitor the quality of care. This was overseen by the registered manager and audited by senior managers of the Local Authority.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to safeguard those people using the service. People we spoke with told us they felt safe using the service and felt able to raise any concerns with staff.

We found evidence that there was an effective recruitment process in place and found policies to back the process up. These included a recruitment procedure, equal opportunities policy and disciplinary and grievance policy.

The provider had an effective system in place to identify, assess and manage risks to the health and safety of people using the service and others.