Background to this inspection
Updated
12 March 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector on the site visit and an assistant inspector telephoned people and their relatives.
Service and service type.
This service provides care and support to people living in 15 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. This service is also a domiciliary care agency. It provides personal care to people living in their own homes.
The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered managers would be in the office to support the inspection.
Inspection activity started on 23 January 2020.
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 Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We checked any statutory notifications that the provider had sent to us. A statutory notification is information about important events which the provider is required to send us by law. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and three relatives about their experience of the care provided. We also spoke with 14 members of care staff, and two registered managers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. We also looked at records of accidents and incidents, complaints and compliments and quality assurance records, A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records and other documents we had asked the provider to send to us.
Updated
12 March 2020
About the service
Midlands Domiciliary Care is a domiciliary care and supported living agency that provides personal care and support to people living in their own homes. At the time of the inspection, 40 people received a service which included personal care. 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.
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. 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’s experience of using this service and what we found
People were safely supported by enough numbers of staff who had been employed through the registered manager’s safe recruitment processes. Staff received training on safeguarding and knew how to identify and report any concerns. Staff administered people's medicines as prescribed. Risks had been assessed and management plans put in place. We noted that not all risks had been acted upon in a timely manner. We have made a recommendation about this. After the inspection the identified risks were rectified.
People's needs were assessed prior to their service starting. The registered managers assessed peoples’ needs and there was a clear dedication to providing high-quality person-centred care to people, to support people to live in their own homes. Staff worked with healthcare professionals to make sure health needs were met. People were not always supported to have maximum choice and control of their lives. We found that some people had not been adequately protected as applications to the court of protection had not been made on their behalf. However, in day to day matters we found that staff supported people in the least restrictive way possible and in their best interests.
People and relatives thought staff were kind and caring. People's privacy and dignity were promoted and maintained by staff who recognised the importance of treating people respectfully. One relative said, “[The staff] are respectful - when they take [my relative] to the shower I know they put towel around him and get him dressed in his bedroom.”
People were involved in their care and were encouraged to share their views and preferences. People had personalised care plans which were regularly reviewed. People were encouraged to be independent, offered choices and their privacy and dignity was maintained. People and relatives were happy with the staff that supported them.
People, relatives and staff all felt able to approach the registered managers and were positive about their leadership style. Quality monitoring was in place and feedback was sought and used to make improvements to the service. There was a complaints policy in place which people and relatives were aware of.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This is the first rating of this service at this location.
Why we inspected
This service was registered with us on February 2019 and this is the first inspection.
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.