Background to this inspection
Updated
11 October 2019
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
This inspection was carried out by one inspector. An assistant inspector sought feedback from relatives of people who use the service through telephone contact.
Service and service type
This service provides care and support to people living in six ‘supported living’ setting[s], 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 two managers 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 48 hours’ notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that the provider had time to speak with people and make sure they were happy for the inspector to visit their home. Inspection activity started on the 22 July 2019 and ended on 20 August 2019. We visited the office location on 22 and 29 July 2019 and visited two of the ‘supported living’ settings on 23 July 2019.
What we did before the inspection
We reviewed information we held about the service including statutory notifications which providers are required to inform the CQC of, such as accident or incidents that have happened at the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with a range of staff including the registered managers’, home managers, support staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records relating to people’s care and support needs across the ‘supported living’ settings which included five people’s care plans and people’s medicines records. We looked at four staff files in relation to recruitment and staff supervision records. A variety of records relating to the management of the service, including policies and procedures were reviewed. We visited two of the six ‘supported living’ settings and spoke with six people and observed people interacting with their support staff.
After the inspection
We continued to seek clarification from the provider to validate evidence found. For example, we looked at training data and quality assurance records. Some of the people who used the service had complex needs which limited their communication. This meant they could not always tell us their views of the service. To ensure we gathered people's views we also spoke with seven relatives to seek their feedback on the support provided to their loved one after the inspection. We also sought feedback from local authority commissioners and professionals and received a response from two health and social care professionals.
Updated
11 October 2019
About the service
Hampshire Domiciliary Service offers domiciliary care to people in their own homes and across six ‘supported living’ settings. People who use the service have learning disabilities, autism spectrum disorders and/or physical disabilities. 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 such as activities, community access and domestic support. At the time of the inspection 19 people required support with personal care tasks across the six ‘supported living’ settings. Each of the ‘supported living’ settings offered different types of accommodation options which included self-contained flats within one building, a single person service and houses of multiple occupancy. No one accessing the provider’s domiciliary care service, which is registered under the same location required support with personal care at the time of the inspection. The provider Autism Hampshire is a registered charity and a not for profit organisation.
People’s experience of using this service and what we found
There were systems and processes in place to review the quality of the services provided to people, however these were not always effective to ensure the provider maintained oversight. For example, findings from this inspection highlighted where improvements were required in relation to the governance and record keeping of communication with the local authority, records relating to actions taken to respond to informal concerns raised by people and their relatives and the governance of staff supervision. We noted there was a clear management structure in place and staff consistently told us they felt supported and could access advice and guidance from the senior management.
We found in day to day practice 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. Where people required additional support to make decisions, practices supported people in line with the principles of the Mental Capacity Act 2005. Staff spoke positively about the range of training opportunities available to support them to continually develop their skills.
People’s care plans were person-centred and focused on their strengths and abilities. Where people required support to manage feelings of anxiety and associated behaviours, staff support was readily available, and responses were proactive. People received appropriate levels of care and support that was responsive to their needs. People were provided with a range of opportunities to engage in social activities and staff encouraged people to build meaningful relationships through extended social networks.
People were protected from the risk of experiencing abuse. Risks to people had been assessed and measures were put in place to ensure their safe management. There were clear safeguarding processes in place to identify, record and respond to all incidents and accidents. People were supported to receive their medicines safely and as prescribed. We received mixed feedback from relatives around movement of staff across the different setting’s, however the provider had an on-going recruitment drive and had taken steps to promote consistency following an organisational restructure. People had access to appropriate levels of support to meet their needs.
People were supported in a kind and caring manner. We observed people had developed positive and trusting relationships with staff which promoted them to achieve positive outcomes. Staff practices promoted an inclusive, non-judgemental culture and people were empowered to embrace their diversity. Staff treated people with dignity and respect and were passionate in promoting person centred care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was previously rated as good at the last comprehensive inspection. That report was published on 08 February 2017.
Why we inspected
This was a planned inspection based on the previous rating.
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.