This inspection was carried out on the 10 and 11 January 2018.Allenby Douglas Ltd is a family run domiciliary care agency that provides personal care and support to people living in their own homes. It provides a service to older adults some of whom are living with dementia and younger disabled adults. Not everyone using Allenby Douglas Ltd receives a regulated activity. CQC only inspects the service received by people provided with ‘personal care’: for example, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 73 people were receiving personal care.
There was a registered manager in post who was present during our inspection. 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.
At the last inspection, the service was rated Good overall with Outstanding in the Caring key question. At this inspection we found that the provider had further developed the service and was now rated Outstanding overall.
People continued to receive a service which was highly caring. People and their relatives found staff to be extremely caring and kind. Relatives described the care and support their family members received at the end of their life as exceptional. People and their relatives felt staff often went ‘above and beyond’ what they expected of them.
The provider took care to ensure staff were compatible with people they supported to promote positive working relationships. People, and where appropriate their relatives, were fully involved in decisions about their care and felt listened to. Staff provided information to people in a way they could understand to enable them to make decisions for themselves.
Staff treated people with the utmost dignity and respect and supported them to remain as independent as possible to enable them to continue living in their own homes. People were supported to follow their interests and to maintain links with family and the local community.
People’s received care and support that was personal to them and took into account their preferences and wishes. People were supported by staff that knew them very well, who worked flexibly and were able to respond to changes in their needs in a timely manner. Staff knew about people’s personal histories and what was important to them, therefore care was tailored to meet their needs.
The provider and registered manager had a clear vision for the service that was shared by staff and management alike.
People were supported by highly motivated staff who were passionate about their roles and making a difference to people’s lives. Staff enjoyed a positive working culture and were involved in developments within the service. Staff felt well supported and valued by the management team and colleagues.
The registered manager and provider were committed to delivering excellent quality care and had a range of checks in place to monitor the quality and safety of the service. They used their findings to make continual improvements to the service, for the benefit of people who used it.
The registered manager and provider actively sought ways of engaging with the community. They worked with partner agencies to ensure current practice and effective care.
People felt safe and comfortable with the care and support provided by staff. People continued to be protected from the risk of abuse and avoidable harm by staff who were knowledgeable about the different types of abuse and knew how to report concerns of abuse or poor practice. Risks associated with people’s needs and their environment were assessed and staff followed guidance put in place in order to minimise these.
People were supported by regular staff who they were familiar with and who were punctual and reliable. The provider followed safe recruitment procedures to ensure potential new staff were suitable to work with people in their own homes.
People received support to take their medicines safely. Only staff who had received training in the safe handling of medicine administered them. Staff monitored people’s health and supported them to access healthcare as and when necessary.
People continued to be supported by staff who had the skills and knowledge to meet their individual needs. Staff were impressed by the range and quality of training available to them and were encouraged to further their careers in care. The provider arranged bespoke training tailored to people’s specific needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the provider’s policies and systems supported this practice.
Not everyone who used the service received support with meals or drinks but those that did were happy with the support they received.
Further information is in the detailed findings below