Thames Valley & North - Domiciliary Care

Updated 10 November 2021

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

Two inspectors carried out the inspection.

Service and service type

This service 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.

The service had a manager 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

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed to ask permission to visit people in their own homes.

What we did before the inspection

We reviewed information we had received about the service since they had registered with the CQC. We sought feedback from the local authority and professionals who work with the service. 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.

During the inspection

We spoke with six people who used the service and seven relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, area managers, support manager and care staff.

We reviewed a range of records. This included three people’s care records. We looked at three 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 10 November 2021

About the service

Thames Valley & North - Domiciliary Care and Supported Living is a 'supported living' service that provides support packages for people with a learning disability or autistic spectrum disorder. Supported living is the name given to support to people who either live in their own homes, either through a tenancy with a housing provider, or live in their own homes through ownership or shared ownership with a housing association.

Not everyone who uses the service receives the regulated activity of 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 a number of ‘supported living’ settings in Oxfordshire. At the time of the inspection 40 people were receiving a regulated activity at 16 addresses.

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

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. We have asked the registered manager to ensure all outcomes of Deprivation of Liberty Safeguard (DoLS) applications are submitted to CQC.

Complaints, concerns and constructive feedback was addressed. However, the provider needs to ensure the process is fully followed and documented as per their policy and procedures.

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and setting maximises people’s choice, control and independence. Support plans were detailed and person-centred. The support plans provided guidance for staff about how best to support people's needs and preferences. The staff received training and support to enhance their skills and understanding in relation to maximising choice, promoting person-centred care and creating the right culture. People had access to a range of activities and social opportunities. Care was person-centred and promoted people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives.

People were protected from the risks of abuse and harm and people and their relatives said they trusted staff to keep them safe. Staff had received training in safeguarding people.

People's support needs were risk assessed and support plans provided staff with the information they needed to manage the identified risks.

Staff were trained to administer medicines and medicines were managed safely.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults and staffing arrangements met people's needs.

Staff had the necessary skills to carry out their roles. Staff had regular training and opportunities for regular supervision and observations of their work performance.

People received tailored support that was centred around their assessed needs, choices and decisions.

People had access to other healthcare services, ensuring a holistic level of support was provided.

No one was receiving end of life care but if this were required, this would be facilitated alongside community healthcare professionals.

The registered manager and staff demonstrated a commitment to people and displayed strong person-centred values. People's choices were respected, and staff supported them to achieve good outcomes. Audit systems were in place to monitor the standard of support people received. Measures to assess improvements and continuous learning were in place.

The service worked in partnership with other health and social care organisations to achieve better outcomes for people using the service.

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 06/08/2020 and this is their first inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.