The Wilf Ward Family Trust Domiciliary Care York

Updated 7 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 18 and 24 October 2018. We gave the service two days’ notice of our inspection because we needed to be sure someone would be available to assist us with the inspection and organise for us to visit people who used the service.

The inspection was carried out by two inspectors on the first day of the inspection and one inspector on the second day.

Before our inspection, we looked at information we held about the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service, such as notifications we had received from the registered manager. A notification is information about important events which the service is required to send us by law. We sought feedback from the local authority quality monitoring team and safeguarding team prior to our visit. We also contacted visiting professionals for feedback about the service.

During the inspection we visited five supported living settings and spoke with nine people who used the service and observed care staff interacting with people. We spoke with the regional registered manager (referred to as the ‘registered manager’ in this report), two deputy regional managers, four service managers, an assistant manager and six support workers. We spoke with one visiting health and social care professional during our inspection and received feedback from another shortly after our site visits. We looked at a range of documents and records related to people’s care and the management of the service. We viewed four people's care records, medication records, four staff recruitment, induction and training files and a selection of records used to monitor the quality of the service.

Updated 7 December 2018

The Wilf Ward Family Trust Domiciliary Care York service provides care and support to people living in 14 ‘supported living’ settings, so that they can live in their own homes 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. At the time of our inspection the service was supporting 31 people with a learning disability or physical disability. People lived in their own homes across the York area, either individually or sharing with up to three other people.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.

Staff were well trained and knowledgeable about how to support people effectively. Staff received a comprehensive induction and regular support. We found that staff training, along with knowledge of best practice, had been used to benefit people who used the service. This included screening people for dementia, and implementing knowledge gained in experiential training to make positive changes to people’s support.

Staff were aware of people’s healthcare needs and supported them to access healthcare services and professionals whenever needed. Staff also considered people’s emotional needs and we found they had been proactive in advocating for people to receive additional support and healthcare where required, to meet their holistic needs. Where people had complex nutritional needs, we found staff followed guidelines and used creative methods to ensure people had a healthy and varied diet.

There were sufficient staff to meet people’s needs. The provider planned staffing according to people’s requirements and used the allocated hours contracted by the local authority for people’s support. The provider conducted appropriate recruitment checks before staff started their employment, to ensure candidates were suitable to work with vulnerable people.

Positive risk taking was promoted, to support people in leading full lives and developing independence skills. Risk assessments and risk enablement plans were in place to help staff reduce risks to people’s safety and well-being. Staff had received training in safeguarding vulnerable adults and knew what action to take should they have any concerns. Safe systems were in place to ensure people received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We observed staff were kind, caring and respectful in their interactions with people. Staff understood how to maintain people’s privacy and dignity. People were involved in decisions about their care. Where people were unable to express their views verbally, staff used their knowledge of people’s preferences, non-verbal communication and feedback from relatives to help ensure their wishes were considered. The provider was very proactive in raising awareness of equality, diversity and human rights issues.

Staff promoted people’s independence; they used varied methods to enable people’s participation in daily living tasks, such as cooking. Support was tailored to people’s needs. Staff used people’s preferred methods of communication, such as Makaton sign language, pictures or symbols.

The provider developed a detailed support plan for each person, to give staff the information they needed to support people in line with their needs and preferences. People took part in a wide range of activities of their choice and we found people had been supported to achieve personal goals and aspirations.

There was a registered manager in post, supported by two regional deputy managers. We received positive feedback about the management team and leadership of the service. Staff felt supported and were motivated to deliver high quality care.

The registered manager had a focus on continual improvement of the service and had further developed the quality assurance system since our last inspection. In addition to quality and compliance audits, there were satisfaction surveys, observations of care practice and systems in place to investigate and respond to any concerns or complaints.

Further information is in the detailed findings below.