West House Domiciliary Service

Updated 20 June 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by an adult social care inspector.

Service and service type:

West House Domiciliary Service provides care and support to people living in the community with a learning disability or who are on the autistic spectrum.

Three senior members of staff are registered as managers 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:

The inspection was announced. Inspection site visit activity started on 14 May 2019 and ended on 29 May 2019. It included visiting people in their own homes. We visited the office location on 14 and 29 May 2019 to meet with the registered managers and office staff; to review care records and policies and procedures and to give feedback on our visits.

What we did:

Before our inspection we reviewed the information we held on the service and completed our planning tool. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least annually to give some key information about the service.

We also reviewed the information we held about the service, such as quality monitoring reports and notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law. We spoke with social workers, health care practitioners and commissioners of care during our regular contact with them. We had received regular updates from the provider based on their quality monitoring.

We met with 14 people in their own homes and with nine support workers who were with them giving support and care. We met all three registered managers and we also met four people who manage individual services, either in the office or in people's homes

We met a relative in a person's home.

We read nine care files and related forms and documents in people's homes and a further two care files on-line in the main office.

We looked at three staff personnel files and had access to documents related to action taken related to disciplinary or competence matters. We saw rosters and training records for the team.

We saw records related to fire and food safety. We saw quality audits and were sent a copy of a West House's business plan called 'Transforming West House'.

Updated 20 June 2019

About the service

West House Domiciliary Service provides care and support to people living with a learning disability or autism. Seven people live alone in their own properties, eight people live in houses with one other person. There are 41 people who live with 3 or 4 other people in shared accommodation.

Not everyone using West House Domiciliary Service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service

People told us they felt safe and staff had received suitable training about protecting vulnerable adults. Accidents, incidents, complaints and concerns were responded to appropriately. People told us they had good support from staff. The registered manager kept staffing rosters under review as people's needs changed. People or their relatives were involved in recruitment. New members of staff were specifically selected to work with individuals and had been suitably vetted.

People told us staff understood their needs. Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

People saw their GP and health specialists. People told us they were supported to budget, shop and cook healthy meals and to look after their health. Staff took the advice of nurses and consultants. The staff team completed assessments of need with health professionals and with the learning disability teams. People were happy with the arrangements for medicines support. Medicines were suitably managed with people having reviews of their medicines on a regular basis.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. 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 told us the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. People in the service, their social workers and relatives, where appropriate, had influenced the content. The registered manager had ensured the plans reflected the person-centred care that was being delivered. People told us they enjoyed the activities, interests and hobbies on offer. Staff could access specialists if people needed communication tools like Makaton or braille. Staff worked with psychologists and psychiatrists when necessary.

The service had three registered managers who dealt with operational matters, complaints and concerns, staffing and quality assurance and training. They consulted people and their representatives in a number of different ways. They were analysing quality monitoring reports to complete the new business plan, 'Transforming West House'. People, their relatives and the staff were enthusiastic about the immanent changes

Rating at last inspection

At the last inspection the service was rated Good (published 8 December 2016).

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.