Background to this inspection
Updated
27 November 2020
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 was carried out by two inspectors.
Service and service type
This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. These settings provided a range of small domestic-type houses and larger blocks of flats. 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 registered manager 24 hours’ notice of the inspection. This was because we wanted to meet with people living in their own homes and needed the provider to make arrangements for this to happen.
Inspection activity started on 29 September 2020 and ended on 9 October 2020.
What we did before the inspection
We reviewed all information we had received about the service since the last inspection. Due to the service being rated as requires improvement, we had been regularly engaging with the new registered manager since the last inspection and this information was used to inform our planning. We have sought regular feedback from the local authority and professionals who work with the service.
We completed a structured conversation with the registered manager and nominated individual in May 2020 using our Emergency Support Framework (ESF) to gain an insight into how the Covid-19 pandemic had affected the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We also conducted virtual interviews with people using and working at the service via video calls on 11 and 12 June 2020 to corroborate the information shared by the management team during the ESF call.
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 visited one of the supported living settings where we met seven people who lived there and observed the support they received from staff. We also had video calls with seven people living at the other three locations where the regulated activity was being delivered. We received feedback either by telephone or email from 12 relatives of people. We also conducted interviews with 15 members staff in addition to speaking with the registered manager and nominated individual.
We looked at a range of records relating to people’s care and the management of the service. These included the support plans for eight people and quality checks that demonstrated management oversight across the service. We also reviewed infection prevention and control measures that had been implemented in response to the Covid-19 pandemic.
After the inspection
We continued to seek clarification from the registered manager to validate our evidence. On 9 October 2020 we had a video call with the registered manager and nominated individual to discuss our inspection findings.
Updated
27 November 2020
About the service
Independence Homes Domiciliary Care Agency is part of Active Care Group, a large national provider had taken over the ownership of Independence Homes. The service provides support for adults with learning disabilities, physical disabilities or mental health needs. At the time of this inspection, the service was providing support within the regulated activity of personal care to 35 people across four ‘supported living’ settings. Support ranged from a few hours per day to 24-hour care. CQC does not regulate the premises used for supported living; this inspection only looked at people’s personal care and support.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.
The management team had continued to develop and improve the quality of support against their own action plan since taking over the running of the service. The outcomes for people at each setting that provided a regulated activity now better reflected the principles of this guidance. As such, people were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Comprehensive assessments and care plans were now the basis of personalised care and ensure that staff supported people in a way that maximised their choice and control, and independence. Staff had a better understanding of people’s needs and were committed to supporting them to live the lives they chose.
Right care:
• Care was more person-centred and promoted people’s dignity, privacy and human rights. People’s individual needs were recognised, and diversity celebrated. Managers had introduced ways of encouraging staff and people to explore each other’s cultures, beliefs and religions in an inclusive way.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff enabled people using services lead confident, inclusive and empowered lives. The management team had worked hard to develop an open and transparent culture which promoted learning and not blame.
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 requires improvement (published 6 February 2020).
Why we inspected
We carried out an unannounced comprehensive inspection of this service in November 2019 where the service was rated requires improvement for the second consecutive time. Following that inspection, the provider completed an action plan to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm the areas which previously required improvement had been addressed. This report only covers our findings in relation to the Responsive and Well-led key questions.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Independence Homes Domiciliary Care Agency on our website at www.cqc.org.uk.
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.