Chorley Domiciliary Service

Updated 17 February 2023

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 was carried out by two inspectors and a medicines inspector.

Service and service type

This service provides care and support to people living in 12 ‘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 a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 16 November 2022 and ended on 02 December 2022. We visited the location’s office on 16 November 2022.

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 visited 4 supported living tenancies and met 11 people. We observed people's interactions with staff and if they were happy and comfortable in their presence. We looked to see if people's homes reflected their personalities, met their physical and sensory needs, was clean and if the culture was caring and empowering. We reviewed nine medicine administration records and looked at medicines related documentation. We observed medicines administration and checked medicines storage.

On the day of the inspection, we spoke with the registered manager, 2 team managers and 5 care staff. On a separate day we spoke with 2 care staff and 2 relatives by telephone. We also received feedback from 2 relatives by email.

We reviewed a range of records. This included 6 people's support plans, several medication records and 3 staff recruitment files. We looked at a variety of records relating to the management of the service, including policies and procedures, meeting minutes, risk assessments and audits.

Updated 17 February 2023

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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Chorley Domiciliary Service supports people who have a learning disability in their own home and provides personal care in line with a 'supported living' model. Supported living is a way of supporting people in their own home with their personal care or support arranged separately with a specialist provider.

Everyone supported by Chorley Domiciliary Service had their own tenancy agreement. At the time of the inspection 36 people were receiving support from the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support

We found medicines were not always managed safely. Records related to medicines administration were not always accurate. The service is planning to introduce a more robust system to address the concerns.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff thoroughly assessed people’s needs and developed plans of support which enabled them to make choices and promoted positive risk taking. People’s homes were personalised, and we could see people’s choices about décor and furniture were respected. Staff had received training to keep people safe and knew what action to take in response to any allegations of abuse.

Right Care

The service provided care that was centred around the person, their needs and their wishes. Staff knew people well and information was available to guide staff on how best to support people. Staff had received training to ensure they could meet people’s needs effectively. The service followed government guidelines to reduce risks related to infections.

Right Culture

The provider had various methods to assess, monitor and improve the quality of the service, however, these had not identified and addressed the issues we found with medicines management. We have made a recommendation about this. People chose how they spent their time and their decisions were respected. Staff told us they felt well-supported and could raise concerns with the management team. We observed people were comfortable and relaxed in the presence of staff and in each of the tenancies we visited, there was a homely and cheerful atmosphere. Staff worked well with external agencies to ensure people’s needs were met.

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 6 November 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can see what action we have asked the provider to take at the end of this full report.

The provider acted to make improvements to ensure people were not at risk of harm from concerns around medicines management.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chorley Domiciliary Service on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to medicines management at this inspection.

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.