Background to this inspection
Updated
28 January 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
One inspector, a member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service and sought feedback from the local authority and professionals who work with the service. 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 consulted the registered manager, the compliance manager and a senior carer regarding current procedures in the service. We reviewed a range of records. This included 2 people’s care records and health and safety records. We looked at a variety of records relating to the management of the service, including 2 staff recruitment records and quality assurance procedures in place.
After the inspection
We continued to review records and polices after the inspection. We reviewed meeting records, medication records, training information and processes to ensure quality in the service. We reviewed policies and procedures in place to ensure a good standard of care. We spoke to 3 relatives and 2 people who used the service to gather feedback on the care and safety of the service. We spoke to 5 staff members about their experience of working for the provider.
Updated
28 January 2023
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.
About the service
Scarborough & District Mencap is an independent charity which provides support to children and adults with learning disabilities. Four services are available at the location, which include a day service and a domiciliary care service providing the regulated activity of personal care. At the time of the inspection the service supported 4 people in the community with personal care.
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:
People were assisted to manage their own medication. However, records and quality checks in this area were lacking. We could not be assured that all areas of medication management were checked for safety and quality. Care plans were in place to help staff understand people’s care needs. Some areas of the records needed expanding to ensure all information relating to that person’s care and the risks to them was detailed and recorded.
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to achieve their aspirations and goals.
People were supported to have maximum choice and control of their lives, however, more detail was needed in the care records to fully explain people’s capacity. This would ensure staff supported people in line with their best interests. We have made a recommendation about this.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People understood information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests that were tailored to them. The service explored opportunities for people to try new activities that enhanced and enriched their lives.
Right Culture:
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff placed people’s wishes, needs and rights at the heart of everything they did. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. The registered manager worked hard to promote an open and honest culture in the service. Staff felt supported int their roles and able to raise any concerns without fear.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service under the previous provider was good (published 5 October 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service and to provide the service with a rating under the new provider.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Scarborough & District Mencap on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified a breach in relation to the governance of the service at this inspection. We have made a recommendation around the providers understanding of the principles of the Mental Capacity Act (2005).
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.