10 May 2022
During a routine inspection
About the service
Croydon Borough is a domiciliary care agency providing personal care to older people, people living with dementia, people living with physical disability and people living with learning disabilities or autism. The service was providing care to one person at the time of the inspection. The person was living with a learning disability.
People’s experience of using this service and what we found
Right Support
The service provided the person with the right support. Staff supported the person to take part in activities they liked doing and attend a local day centre, so they had a fulfilling and meaningful everyday life. The service made adjustments for the person and their relative so they could be fully involved in discussions about how the person received support, such as holding meetings at the person's home. The service worked with the person and their relative to plan for when the person experienced periods of distress. Staff supported the person and their relative so the person could access specialist health care support in the community. The service supported the person and their relative to make decisions following best practice in decision-making. Staff supported the person with their medicines in a way that achieved the best possible health outcome. Staff communicated with the person in ways that met their needs.
Right Care
The service had not always provided the person with the right care. The provider had not always provided the person with sufficiently trained and experienced staff. Some of the staff used to provide the person with care when their usual care workers were not available had not received training to work with epilepsy, learning disabilities, behaviours that some people may find distressing and PEG (percutaneous endoscopic gastrostomy) tube support. PEG is a procedure in which a flexible feeding tube is placed through the abdominal wall and into the stomach and allows nutrition, fluids and/or medicines to be put directly into the stomach, bypassing the mouth. Staff had not always followed medicines administration guidance and best practice. We found no evidence the person had been harmed. However, this meant the person had sometimes not received the right care.
Staff promoted equality and diversity in their support for the person. They understood their cultural and religious needs and preferences and provided them with culturally appropriate care. The person received kind and compassionate care and staff respected their privacy and dignity. Staff understood and responded to the person's individual needs. The person had individual ways of communicating, including using body language and sounds for example and the person could communicate with staff because staff supported them consistently and understood their individual communication needs. The person's care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Right Culture
The service was not always sufficiently person-centred. The provider had not always provided the person with replacement staff that had personalised information about them. The provider had not always understood and assured quality performance. They had not regularly carried out audits and the audits they had carried out were ineffective because they had not identified the issues we found during our inspection.
The person received good quality care, support and treatment the majority of the time because their usual care workers were trained and experienced and had good knowledge about them and could meet their needs and wishes. Staff knew and understood the person well and were responsive, supporting theirs and their relative's aspirations for them to live a quality life of their choosing. Staff turnover was very low, which supported the person to receive consistent care from staff who knew them well. The person and their relative were involved in planning the person's care. The provider obtained feedback from the person's relative about the quality of support provided to the person.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support, right care, right culture.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.