The Field Lane Domiciliary Agency - Southend-on-Sea

Updated 31 December 2022

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 Care Act 2014.

Inspection team

The inspection team consisted of one inspector and an Expert by Experience. An Expert by Experience is a person who has experience of this type of service. We inspected on 02 November 2022. Telephone calls to people’s relatives for feedback took place on 04 November 2022.

Service and service type

This service provides care and support to people living in two ‘supported living’ settings, 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

Before the inspection, the provider completed a Provider Information Return (PIR). We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed previous reports and notifications that are held on the CQC database. Notifications are important events that the service must let the CQC know about by law. We also reviewed safeguarding alerts and information received from a local authority. We used all of this information to plan our inspection.

During the inspection

We communicated with 3 people and 6 relatives and observed interactions with staff. We spoke with the registered manager, 2 project managers and 4 care workers. We reviewed 4 care files, medication records and information held in relation to the running of the service such as audits, training matrix, meeting minutes and a staff file.

Updated 31 December 2022

About the service

The Field Lane Domiciliary Agency Southend-on-Sea is registered to provide personal care. The people using this service are living with various types of learning disabilities. They are supported by the agency to live as independently as possible in a supported housing environment. The agency is currently supporting people living in two separate premises in the Southend area. Both houses are staffed 24 hours a day.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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.

Right Support:

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

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 support this practice.

Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

Right Care:

People were cared for and supported by staff who had received the appropriate training.

There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Medication was dispensed by staff who had received training to do so.

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 eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required. The environment was well maintained and suitable for people.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care.

Right Culture:

The provider had processes in place to check staff were safely recruited; however, not all relevant information was documented for new applicants.

We have made a recommendation about the provider’s recruitment processes.

The registered manager responded to complaints received in a timely manner. People were supported to make plans for the end of their life. However, these were not fully documented.

We have made a recommendation for people to have detailed end of life care plans in place.

People and their relatives and advocates were involved in the planning and review of their care. Care plans were reviewed on a regular basis. People were supported to follow their interests and participate in social activities.

The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection

The last rating for this service was Good (last report published 02 August 2019).

Why we inspected

We received concerns in relation to people unable to make choices about the activities they took part in and people not being encouraged to live an independent life. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 is good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Field Lane Domiciliary Agency – Southend-On-Sea on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.