Richmond and Kingston DCA

Updated 29 March 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service also provides care and support to people living in a number of '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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours' notice of the inspection as we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 27 February 2023 and ended on 14 March 2023. The inspection visits took place on 28 February and 1 March 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke in person with the registered manager. We spoke with 10 people using the service. They did not comment directly on whether the service was safe and well-led. We spoke with 8 relatives or advocates, 10 staff, and 6 healthcare professionals to get their experience and views about the care provided. We reviewed a range of records. They included 5 people’s care plans and risk records. We looked at 7 staff files in relation to recruitment, training and staff supervision. We checked a variety of records relating to the management of the service, including staff rotas, training, and service level audits. After the visit we continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. This included staffing and training information, and provider quality assurance audits. We received the information which was used as part of our inspection.

Updated 29 March 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports the Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

About the service

Kingston and Richmond DCA is a domiciliary care and 'supported living' service and registered to provide personal care and support to people who have a learning disability or complex needs in their own homes. 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.

At the time of the inspection there were 26 people receiving personal care in 8 different supported living settings and also in their own homes. We visited people who lived in self-contained flats, adapted houses where people had their own bedroom and sometimes individual or shared bathrooms and as well as shared communal areas.

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

At the last inspection the service provided was not always safe for people to use as their medicines were not always managed safely and there were poor hygiene practices. Support visits did not always occur at the agreed time or last for the agreed duration and learning from incidents and accidents was not always done in a timely way. The service was not always well-led as the quality assurance system was not always used appropriately to assess and monitor the quality of the service and some audits were incomplete. The provider did not always demonstrate a strong focus on capturing learning to improve the service. The analysis of incidents and accidents was not always robust and there was inconsistent oversight of the operations at the various settings.

At this inspection people’s medicines were managed safely, good hygiene practices were in place, support visits took place on time and lasted the agreed duration and accidents and incidents were learnt from. The quality assurance system identified, monitored and addressed service shortfalls, audits were completed and operations at the various settings were appropriately overseen.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People received a service that was safe for them to live and staff to work in. The quality of the service provided was regularly reviewed, and changes made to improve people’s care and support as required. This was in a way that was best suited to people. The service had established working partnerships that promoted people’s participation and reduced their social isolation.

Right Care

Enough, well trained and appropriately recruited staff supported people to live safely, whilst still enjoying their lives. People and staff had risks to them assessed, monitored and reviewed. Complaints, concerns, accidents and incidents and safeguarding issues were appropriately reported, investigated and recorded. People’s medicines were safely administered by trained staff.

Right culture

The service leadership and management were identifiable, transparent and there was a culture that was honest, open, and positive. The provider’s vision and values were clearly defined, and staff understood and followed them. Staff were aware of their responsibilities, accountability and prepared to take responsibility and report any concerns they may have.

Rating at last inspection

The last rating for this service was Requires Improvement (published 29 June 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, and Well-led which contained a requirement. A decision was made for us to inspect and examine the risks associated with these issues.

CQC has introduced focused inspections to follow up on previous breaches and to check specific concerns.

As no concerns were identified in relation to the key questions Effective, Caring and Responsive, we decided not to inspect these questions. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Richmond and Kingston DCA on our website at www.cqc.org.uk.

Follow up

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