Archived: Domiciliary Care Agency East Anglia

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask: Is the service safe, is the service effective, is the service caring, is the service responsive, and is the service well led? Below is a summary of what we found:

Is the service safe?

The registered manager for the service told us that there were team leaders responsible for organising the support for each house in which people lived and these were all run separately, with their own staff teams. There were systems in place for out of hour's support which ensured that staff and people using the service could contact someone in an emergency. There were service user guides in each house which told people who used the service what they could expect from the service. It also told them who they should contact if they needed help or were unhappy about any aspect of the service. This meant people had the information they needed and support was available if people required it.

There were effective staff recruitment processes in place and staff were supported through adequate induction and training. This meant people were supported by staff who were assessed as suitable to work with vulnerable people. Staff received the required training to enable them to deliver care safely.

Staff received training for key aspects of their role including protecting people from abuse and administering medication safely to people.

Is the service effective?

There were systems in place to continually evaluate the effectiveness of the service to make sure it met people's needs and people were satisfied with the service provided. Frequent audits ensured the service was safe or where shortfalls were identified effective actions were taken.

Is the service caring?

Staff we spoke with were knowledgeable about the people they were supporting. We observed positive relationships and staff encouraging people to be as independent as they could. Staff understood people's needs and were able to communicate effectively with people where they had limited verbal skills.

Is the service responsive?

The service responded to people's changing needs but this was not always illustrated by people's records. We could not see from people's records how people's needs were kept under constant review or how everyone was supported in reaching their goals.

We saw that staff worked flexibly and could meet a change in people's needs. However we noted that some people did not have enough staff support to enable them to fully participate in the community.

Is the service well- led?

The manager was experienced and told us they were well supported by their manager. They had a great deal of knowledge about the people they supported. There were clear lines of responsibility and accountability. Each member of staff we spoke with felt well supported and equipped to do their job. They said the training they had received was excellent and they received formal and informal support and appraisal of their performance. Staff development was encouraged and staff spoken with were confident in their roles.

We found that people who used the service were not protected from the risk of abuse because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines. We found in one house where four people lived, that people were placed at risk by the current practices around management and administration of medication.

We found that people's care and treatment was mostly planned and delivered in a way that would ensure their safety and welfare. However we raised some points for the immediate attention of the regional manager to ensure that care was being provided appropriately. The provider had systems in place to regularly assess and monitor the quality of service that people receive.