We carried out a review of the data available to us about iDirect - West Dorset on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about iDirect - West Dorset, you can give feedback on this service.
iDirect provides personal care and support to people living in their own home or their family home. People using the service included people living with a learning disability, autism and/or mental health conditions. At the time of our inspection, there were 9 people being supported by the service who received personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Where they do we also consider any wider social care provided.
People's experience of using this service and what we found
Following the last inspection, people’s experiences had improved significantly and they now received outstandingly effective and responsive care and support from a well led and constantly improving service.
Without exception everyone we spoke with or had feedback from was full of praise for the service and its staff.
There was a strong and knowledgeable provider and management team who led by example and who were committed to continually monitoring and developing the service. The provider, management team and staff were passionate about the service. The service was forward thinking and innovative and worked creatively with outside organisations to promote the well-being of people with learning disabilities, autism and mental health needs. They focused on the principles of citizenship and being part of the community and constantly worked with people to achieve this. People, relatives, and staff worked together to support and develop the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes and be valued as citzens. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People were supported to have maximum choice and control of their lives and supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People received a truly person-centred service which promoted excellent outcomes for them. This included supporting their independence and control over their own lives. Each person was respected as an individual, with their own social and cultural diversity, values and beliefs.
Staff were highly skilled and motivated. Staff had an in-depth knowledge of the people they supported and worked with them to improve their quality of life. They provided flexible care and support in line with a person's needs and wishes.
People were safe and risks to people were identified, assessed and managed safely with an enabling and empowering focus so no one was restricted. Staff supported people to take positive risks and were flexible in their approach.
There were enough staff to meet people's needs safely and recruitment processes were robust with people included so they had a say about who might be employed to support them.
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 15 May 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Outstanding.
iDirect delivers domiciliary personal care to people with learning disabilities, mental health conditions and autism. Personal care was provided to 12 people who lived in their own homes. There was a central office base which had an open plan reception, training area and kitchenette facility. There was a separate office with three desks where the management worked from.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. However, people’s records did not always contain an assessment of their capacity. Where decisions had been made in people’s best interests around their care and treatment these were not always being recorded fully. This meant we were unable to tell, if decisions were specific, made in consultation with appropriate people such as relatives or were being reviewed. We did not find that people had been disadvantaged or that decisions taken were not in people's best interest.
People and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training.
Personalised care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had a care file which also included outcomes and guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.
Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines. Medicine Administration Records reviewed showed no gaps. This told us that people were receiving their medicines.
Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, autism, epilepsy, diabetes and learning disability.
Staff told us they received regular supervisions which were carried out by management. We reviewed records which confirmed this. A staff member told us, “I receive regular supervisions and find them useful”.
People were supported with shopping, cooking and preparation of meals in their home. The training record showed that staff had attended food hygiene training.
People were supported to access healthcare appointments as and when required and staff followed GP and community psychiatric nurses (CPNs) advice when supporting people with on going care needs.
People told us that staff were caring. During home visits we observed positive interactions between staff and people. This showed us that people felt comfortable with staff supporting them.
Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes, interests and communication needs. Information was available in various easy read and pictorial formats. This meant that people were supported by staff who knew them well.
People had their care and support needs assessed before using the service and care packages reflected needs identified in these. Outcomes were set by people and outcome focused reviews took place. These evidenced that people were actively supported to work towards their outcome areas and that achievements were recorded. Additional support was highlighted and provided. We saw that these were regularly reviewed by the service with people, families and health professionals when available.
People, staff and relatives were encouraged to feedback. We reviewed the findings from quality feedback questionnaires which had been sent to people and noted that it contained mostly positive feedback. The service was reviewing this process as part of their development plan.
There was an active system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints in place. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.
Staff had a good understanding of their roles and responsibilities. Information was shared with staff so that they had a good understanding of what was expected from them.
People and staff felt that the service was well led. The management team and director encouraged an open working environment. People and staff alike were valued and worked within an organisation which ensured a positive culture was well established and inclusive. All the management had good relationships with people and delivered support hours to them.
The service understood its reporting responsibilities to CQC and other regulatory bodies and provided information in a timely way.
Quality monitoring visits and audits were completed by the management team and an external person. We found that smoke detector checks in one person’s house had been overlooked by this external auditor. The deputy told us they would complete a service check this month. Quality monitoring completed by the service appeared to be robust and effective. The checks by the external auditor were being addressed by the director who was in the process of bringing in Quality Checkers. Quality Checkers are paid to check health and social care services. They perform a unique role in monitoring services. People who provide services can miss important information or fail to ask a crucial question as they have not experienced that service. Quality Checkers have direct experience of using services and know what to ask and where to look to find answers.