Archived: West Midlands Domiciliary Care Branch

This inspection took place on 23, 24 and 26 September 2016. At our last inspection on 26 September 2014 the provider was meeting the requirements we inspected. West Midlands Domiciliary Care is registered to provide personal care services to people with learning disabilities living in their own homes. At the time of our inspection 30 people were being supported at 11 premises.

There were two registered managers in post. 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 working more than their contracted hours to provide care for people and felt that internal communication could be improved. People’s risk were identified, assessed and managed in a way that supported their independence. People were protected from unnecessary harm by staff who knew them well, understood how to recognise signs of poor care or abuse and knew how to escalate their concerns. Staff understood why people’s anxieties sometimes led to behaviours that challenged their safety and that of others and had plans in place to avoid incidents and manage risks.

People were supported to take their medicines correctly and safely. Staff had access to training to improve their knowledge of care and enhance their skills. Staff sought people’s consent before providing care and supported people when they needed help with their decision making.

People were provided with a varied diet and plentiful drinks which met their individual needs. Mealtimes were flexible and based around people’s plans for the day. People received kind and compassionate care. Staff supported people to maintain their dignity, independence and privacy. Staff gained information about what was important to people so that they could provide care which met their preferences. People were able to spend their time doing what they enjoyed when they were at home and had opportunities to go out alone or with support from staff.

People were provided with information about raising concerns or complaints and were happy to speak with staff about their worries. People were given opportunities to share their views of the service and were involved in the recruitment of staff. There were audits in place to monitor the quality of the service to identify where improvements could be made.

Is the service safe?

People told us they felt safe. One person told us, "I feel safe and happy." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.

Staff knew about risk management plans and told us they supported people in line with those plans. This meant people were cared for in a way that protected them from harm.

The provider worked well with health care providers to ensure people's health needs were met and they were protected against harm.

The provider had robust recruitment procedures in place to ensure staff were of good character and had the skills and knowledge to support people in a safe way.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people and helped the service to continually improve.

Is the service effective?

People's care needs were assessed with them. We saw evidence that people were involved in their care planning and reviews by using communication methods that met their needs. We saw care plans were regularly updated.

Where people had complex needs that required the input of specialist health care services, assessments had been made by the appropriate professionals. Their recommendations were carried out by staff. This meant the provider worked well with other services to ensure people's health care needs were met.

Staff had been trained to meet the specific care needs of the people they supported.

Is the service caring?

People told us they were supported by staff that were kind and caring. One person told us, "The staff are wonderful."

People's preferences, interests and diverse needs had been recorded and people told us care and support was provided in accordance with their wishes.

Is the service responsive?

People had the opportunity to plan and engage in a range of different activities each day.

People were asked their views about the service using appropriate communication methods and the provider acted on comments that people made.

Where care staff had noticed people's changing needs, their care plans were updated to reflect this. We found staff discussed people's care needs with them on a regular basis.

Is the service well led?

The provider had quality assurance and risk management systems in place. We found the service manager checked that risks were managed effectively.

The provider sought the views of people who used the service. Records seen by us indicated that shortfalls in the service were addressed where they had been identified.

Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure people received a good quality of care.

Staff told us the service was well organised and they felt supported by their managers.

We spoke with the two registered managers at the provider's registered location.

We were told that the provider supported people with their personal care in ten supported living houses.

Two days after our visit to the registered location, we visited one supported living home. The service provided 24 hour personal care support to people with learning disabilities. During this visit we spoke with the staff team, the three people who used the service and one visiting relative.

We observed that people living at the home appeared relaxed and calm around the staff team. We observed positive interactions between the staff and people who used the service.

We found that consent was obtained from people who used the service in relation to their care.

We found that the care needs of people who used the service were met.

We found that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw that there were effective recruitment and selection procedures in place. We could not confirm that all staff were suitably trained as we were informed that the training matrix was inaccurate.

We found that the provider had a system in place to regularly assess and monitor the quality of service that people received. We found that some improvements could be made to the quality assurance system.