Dolphin Homes Ltd Supported Living Services Office

Updated 7 September 2022

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by three inspectors and one Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to ten people living in six ‘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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

Notice of inspection

We gave the service seven days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 24 June 2022 and ended on 5 July. We visited the location’s office on 24 June 2022.

What we did before the inspection

The provider sent copies of policies, business continuity plan, staff meeting minutes, incident and accident records, and quality assurance records prior to the inspection visit, which we reviewed remotely. We also sent the provider a set of additional questions related to providing care in supported living settings. These questions helped us to understand people’s experience of receiving care and identify examples of good quality care. This information helps support our inspections.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We visited four people in one supported living setting and spoke with another by telephone. We spoke with six relatives via telephone to get feedback about their family members care. We spoke with eight members of staff including the registered manager, supported living services manager, and care staff.

We reviewed a range of records. This included three people’s care records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 September 2022

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 CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic

About the service

Dolphin Homes Ltd Supported Living Services Office is a supported living service providing personal care to people with a learning disability and or autistic people in their own houses and flats. At the time of inspection there were ten people using the service in six separate supported living settings. Some people lived on their own, whilst other people lived in shared accommodation. People received a variable number of care hours per week, depending on their assessed needs.

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.

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

Right Support

We found that not all staff had completed the appropriate training for their roles and in how to deal with incidents involving people becoming challenging to them. There was not a robust effective system in place to ensure that the provider employed people who were suitably qualified, competent and experienced. This placed people at risk of receiving inappropriate or unsafe care.

People had choice and control around their care arrangements. Care focussed on people’s abilities and promoted their independence.

People were supported to maintain relationships that were important to them and care was

arranged so people could access the services and activities which they wished. People's care plans identified how they would like to be supported and what they would like to achieve with the help of care and support.

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.

Right Care

We identified concerns around recording of medication administration and training records. We found no evidence that people had been harmed, however, there were failures to record, monitor and improve the quality and safety of the service, and failure to maintain accurate records

Staff were respectful of people’s dignity, privacy and treated them as individuals with their own beliefs, thoughts and aspirations.

People told us they were happy with their care. People or their relatives felt comfortable in raising issues or concerns. There were systems and processes in place to safeguard people from abuse. However, not all staff we spoke to knew how to access the policies on safeguarding or whistleblowing. The provider had an open and transparent approach where people, relatives and professionals were kept informed about key events related to care.

Right Culture

Although we found oversight issues around governance and training, from our observation of the registered manager and their staff with people supported, the provider’s management displayed caring and person-centred values . They modelled this behaviour to staff and set expectations that these values should be integral to staff’s working practice.

People were supported and treated with dignity and respect. Staff used accessible ways to communicate with people personalised to meet their needs. Relatives said that staff listened to what they had to say and worked with them to communicate appropriately with people and in a way people could understand.

The provider worked well with external stakeholders to meet people’s changing needs and ensure people had smooth transitions when moving between different services.

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

Rating at last inspection

This service was registered with us on 20 March 2020 and this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staff not receiving the required training and the provider not keeping accurate and accessible records.

Please see the action we have told the provider to take at the end of this report.

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