Background to this inspection
Updated
23 February 2024
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
The inspection team consisted of an inspector and a medicines inspector.
Service and service type
This service provides care and support to people living in nine ‘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.
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 not a registered manager in post. The provider had recently recruited a manager to the post and was going through the application process.
Notice of inspection
The inspection was announced. 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 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 since the last inspection. We 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 spoke with 9 people who used the service about their experience of the care provided and 4 relatives. We spoke with 8 members of staff including senior manager, manager, team leaders, and support workers. We spoke with 2 professionals. We reviewed a range of records. This included 4 people's care records and various medication records. We reviewed 3 staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.
Updated
23 February 2024
About the service
Delrow Community is a domiciliary care agency providing personal care to people with a Learning disability and autistic people. At the time of our inspection there were 50 people using the service, however 14 people were being supported under the regulated activity of personal care.
People’s experience of the 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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way; however this was not always documented appropriately and the policies and systems in the service did not support this practice.
Staff supported people to play an active role in maintaining their own health and wellbeing and enabled people to access specialist health and social care support in the community.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes.
Right Care
The provider made sure that there was enough skilled staff to meet people's needs and keep them safe, as well as ensuring they met best practice guidance. Staff had training; however further specific training was required to meet people’s individual needs. This was something the provider planned to continue developing.
People had risk assessments that detailed their immediate risks and how to mitigate the risk.
People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The registered manager and staff worked well with other agencies to do so. People were supported by staff who treated them with respect and staff were kind and caring.
Right Culture
Professionals spoke positively about the responsiveness of staff, however they felt that the communication with the management needed to improve.
Managers completed quality audits which covered all aspects of care, although some of these audits did not identify some of the concerns we identified as part of the inspection.
People and staff were involved in the running of the service and fully understood and considered people's protected characteristics.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 30 March 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and recommendations
We have identified breaches in relation to documenting decisions made in people’s best interests. We also recommended the provider reviews the training they offer to ensure that staff are skilled to support people to meet their individual needs. 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.