21 December 2023
During an inspection looking at part of the service
East Office is a domiciliary care agency registered to provide personal and nursing care to people living in their own homes. Most people due to the complexity of their care and treatment needs had 24/7 care, or care for a large proportion of the day and night.
The service is able to support children up to 18 years of age, younger and older adults, people with a learning disability or autistic people, and people living with dementia, a physical disability and/or sensory impairment. At the time of the inspection, 39 people were using the service, all of whom received personal, and/or nursing, care.
People's experience of using this 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 assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support for anyone whose primary care need was for a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support
Staff were knowledgeable and skilled in applying safeguarding procedures and knew to whom they could report any concerns. The provider acted effectively where safeguarding issues or allegations were identified. People received their medicines as prescribed by trained and competent staff.
The service and the staff team took on board learning when things went wrong and effective changes were implemented. Enough skilled and suitable staff had been recruited and most recruitment records showed the provider had checked they were safe to work with people. However, best practice guidance for checks for staff from outside the UK did not always include a police check. We were assured this would be addressed. A relative said there was enough staff cover, and only in exceptional circumstances did they have to support their family member's care needs until replacement staff arrived.
Right Care
People were supported to have maximum 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. A person told us they chose when to have their medicines and how. Other professionals were involved so people’s care and treatment was always in their best interests.
Risks to people were identified and safely managed. Staff knew how to keep people safe, such as when using medical equipment and hoist and slings used to support people to reposition. Staff adhered to good infection prevention and control practices. A person told us staff always washed their hands between each care task.
Right Culture
In the main, quality monitoring systems, oversight and governance was effective in driving improvements. Although there were some missed opportunities to improve the accuracy and details in people’s records. The registered manager led by example and had fostered an open and honest staff team culture. Staff put people’s needs at the forefront of their care and treatment needs and staff upheld people’s human rights to have a good quality of life.
People, their relatives and staff had a say in how the service was provided. The provider worked well with other organisations, and this helped people live a full meaningful life. A person had praised the provider for standing up for their human rights so they could live more independently at home. Another person had, for the first time ever, been on a holiday which they had thoroughly enjoyed.
Why we inspected
The inspection was prompted in part due to concerns we received about safeguarding and risks to people, the culture and management of the service. A decision was made for us to inspect and examine those risks. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for East Office on our website at www.cqc.org.uk.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led section of this report. The overall rating for the service has remained good. This is based on the findings at this inspection.
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 29 April 2022).
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.