Independent Lifestyle Options Domiciliary Care Also known as The Garden House

Independent Lifestyle Options Domiciliary Care is a domiciliary care agency providing personal care to people living in their own homes in the community. The service provides support to people with physical disabilities. 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. At the time of our inspection the service were providing personal care to four people living together in one house in the community.

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

People were safe. Staff had been trained to safeguard people from abuse and knew how to manage risks to people, to keep them safe. There were enough staff to support people and meet their needs. The provider carried out recruitment and criminal records checks on staff to make sure they were suitable to support people. Staff followed current practice when providing personal care and when preparing and handling food which reduced infection and hygiene risks.

People were happy with the care and support they received from staff. People were involved in planning their care and support and could state their preferences for how this was provided. They received the care and support that had been planned and agreed with them because staff knew them well and understood how their needs and preferences should be met.

Staff received training to help them meet people’s needs. Staff were well supported and encouraged to continually learn and improve in their role. They put people’s needs and wishes at the heart of everything they did.

Staff helped people to eat and drink enough to meet their needs. Staff understood people’s healthcare needs and how they should be supported with these. Staff were caring and treated people well. They respected people’s rights to privacy, dignity and independence.

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.

People were supported to undertake activities that reflected their interests and preferences. They were supported to maintain relationships with the people that mattered to them.

The service was managed well. The management team understood how people’s needs should be met and monitored and reviewed the quality and safety of the service. They checked with people at regular intervals that the care and support provided was meeting their needs and sought their views about how the service could improve. There were systems in place to investigate accidents, incidents and complaints.

The service worked with healthcare professionals involved in people’s care and acted on their recommendations to deliver care and support that met people’s needs.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 9 February 2018).

Why we inspected

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This inspection took place on 10 January 2018. At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

Staff continued to ensure people were protected if they suspected they were at risk of abuse or harm. Staff were given appropriate guidance on how to support people to minimise identified risks to keep them safe from harm or injury at home and in the community. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care and when preparing and storing food.

There were enough staff to support people safely. The provider maintained robust recruitment checks to assure themselves of staff's suitability and fitness to support people. Staff received regular and relevant training to help keep their knowledge and skills up to date with best practice. Staff were supported by the provider to meet the values and vision of the service which were focussed on people experiencing good quality care and support. Staff knew people well and had a good understanding of their needs, preferences and choices. They were aware of people’s preferred communication methods and how people wished to express themselves.

People remained actively involved in planning and making decisions about their care so that they received support that was personalised and which met their specific needs. Staff used information and guidance, based on best practice and current standards to plan and deliver care that would support people to experience good outcomes in relation to their healthcare needs. Senior staff reviewed people's needs regularly to ensure the support they received continued to meet these. People were encouraged to keep healthy and well and helped to access healthcare services when needed. They were supported to eat and drink enough to meet their needs and to take their prescribed medicines, where this support was provided by staff.

People were encouraged to do as much as they could and wanted to do for themselves to retain their independence and control over their lives. People were supported to participate in activities and events to meet their social and physical needs and to build and maintain friendships and relationships with others. Staff were kind and caring and treated people with dignity and respect. They ensured people's privacy was maintained particularly when being supported with their personal care needs.

People were asked for their consent before care was provided and prompted to make choices. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

People, their relatives and staff were asked for their views about the quality of care and support provided and how this could be improved. They said senior staff were approachable and supportive. Senior staff monitored the quality of care and support provided. They undertook surveys and regular audits of the service and took appropriate action if any shortfalls or issues were identified through these. If people were unhappy and wished to make a complaint, the provider had arrangements in place to deal with their concerns appropriately.

The service had a registered manager in post who was aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.

Independent Lifestyle Options Domiciliary Care is a small service that provides personal care to people with learning disabilities. At the time of our inspection they were providing care and support to four people living together in one house in the local community.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us they were safe when being supported by staff. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk and knew how and when to report their concerns if they suspected someone was at risk of abuse so that they could be sufficiently protected. They were also trained to support people in a way which protected them from harm that could arise from discrimination at home and in the community.

There were appropriate plans in place to ensure identified risks to people were minimised. Staff had a good understanding of the specific risks to each person and what they should do to minimise these without restricting people’s rights to undertake activities or tasks.

There were enough suitable staff to care for and support people. Senior staff planned staffing levels to ensure there were enough staff to meet the needs of people using the service. The provider carried out appropriate checks on staff to ensure they were suitable and fit to work at the home. Staff received relevant training to help them in their roles. Staff were supported by senior staff and were provided with opportunities to share their views about how people’s experiences could be improved.

People’s consent to care was sought and obtained before care and support was provided. All staff had received training on the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the act. People were supported to make decisions and choices about their care and support needs. Their support plans reflected their specific needs and preferences for how they wished to be cared for and supported in such a way as to retain as much control and independence over their lives as they wanted. These were reviewed regularly with them by staff who checked for any changes to people’s needs.

People were encouraged to eat and drink sufficient amounts and maintain a healthy and balanced diet. Staff supported people to keep healthy and well and ensured people were able to promptly access healthcare services when this was needed. Where this was relevant, staff made sure people received their prescribed medicines promptly.

People and their relatives told us staff looked after them in a way which was kind, caring and respectful. Staff knew people well. Their priorities were clearly focussed on ensuring that people's care and support needs were met and they had a good understanding and awareness of how to do this. Staff respected people’s right to privacy and dignity. They knew how to provide care and support in a dignified way and which maintained people’s privacy at all times.

People said they felt comfortable raising any issues or concerns directly with senior staff. There were arrangements in place to deal with people's complaints, appropriately.

The senior staff team demonstrated good leadership. They sought people’s views about how the care and support they received could be improved. They ensured staff were clear about their duties and responsibilities to the people they cared for.

Staff carried out regular checks of key aspects of the service to monitor and assess standards. They took appropriate action to make changes and improvements when this was needed. They also used learning from incidents and events to drive improvements within the service.

We saw there were adequate staff recruitment and safeguarding procedures in place. Staff received appropriate support and were provided with both essential training and wider training opportunities if they were interested. The provider had systems in place to gather information about the quality of the service and this information was acted upon.