Quinn Domiciliary Agency Limited provides personal care and support to a small group of people with learning disabilities and mental health needs in their own homes. At the time of our inspection, 12 people were being supported across five locations in Essex.

This inspection took place on 29 September. This was an announced inspection. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to know that someone would be available.

There was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were safeguarding procedures and processes in place to ensure the safety of the people who used the service. Incidents were recorded and analysed and personalised risk assessments were in place to reduce the risk of harm to people. and were regularly reviewed. People received their medicines as they had been prescribed and there were robust procedures for the safe management of medicines. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

There were sufficiently skilled and knowledgeable staff on duty who were trained and supported to meet people's assessed needs. Staff worked flexibly to ensure that people could take part in activities that they enjoyed. Robust recruitment and selection processes were in place to ensure that staff were of a suitable character.

Staff received training to ensure that they had the necessary skills to meet the needs of the people who lived at the service and had regular supervision and appraisals.

People using the service were supported to make choices about what they did and information was provided in a format that they could understand. Staff had supported people by providing information about healthy living choices. People received care and support which was planned and delivered to meet their specific needs and people's consent was sought before they were provided with care and support. The service was up to date with the Mental Capacity Act 2015.

Staff meetings were arranged, so that staff could discuss and be involved with the smooth running of the service. People and their relatives were regularly asked for feedback to enable improvements to be made. There was a complaints procedure in place and people knew how to make a complaint if they were unhappy with the service. The service had a statement of purpose and an effective quality assurance system was in place.

People, their relatives and staff spoken with had confidence in the management team and felt the service had clear leadership. There were effective systems to assess and monitor the quality of the service and address any concerns.

The service met all relevant fundamental standards.

Further information is in the detailed findings below.

This inspection took place on 12 August 2015 and was announced.

Quinn Domiciliary Agency Limited offers personal care to a small group of people with learning disabilities and mental health needs in their own homes. The organisation offers support to people living in Wickford and the surrounding area. At the time of our inspection there were 14 people using the service.

The service had a registered manager at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We had carried out an announced inspection on 17 February 2014 and found that the service required improvements to the administration of medicines. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the improvements required.

At our inspection on 12 August 2015, we found that improvements had been made to the processes for supporting people to take their prescribed medicines safely.

People were safe and staff knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk.

People were supported by sufficient numbers of staff who were safely recruited, were regularly supervised and had the skills to meet people’s complex and varied needs. New and existing staff had access to a flexible and comprehensive training programme.

The provider had policies in place with regard to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The Act, Safeguards and Codes of Practice were in place to protect the rights of adults by ensuring that if there was a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

Staff had a good understanding of the importance of obtaining consent and suitable measures were in place where people lacked the capacity to make decisions. People were supported with meals and staff at the service worked with health professionals to support people with their health care needs.

People’s independence and culture was promoted by staff, and they were involved in decisions about their care. People were treated with kindness, dignity and respect by staff who knew them well and their rights were upheld.

Detailed assessments had been carried out and personalised care plans were in place which reflected individual needs and preferences. The provider had an effective complaints procedure and people had confidence that concerns would be investigated and addressed.

The service benefitted from a clear management structure and visible leadership. A range of systems were in place to monitor the quality of the service being delivered and to drive improvements.

We found a service that had not grown and developed their regulated service since our last visit, but had been supplying staff to people as part of a direct payments scheme. These people were set to come under this regulated service shortly after our visit.

We saw that there were plans to assess people’s needs and staff were recruited and trained to take on that role. One person who used the service told us they were happy with the support they received and that they liked the staff supporting them.

We found that care plans were supported with assessments from professionals and had dynamic risk assessments in place that people using the service agreed with to keep them safe. We found that medicines management could improve as recording of medication did not protect people.

We had the opportunity to talk with one person who used the service; they told us that they were happy with the care they received. They told us that they were supported in the way they wanted, had their privacy and dignity maintained and that they were able to express their views and individuality.

The person we spoke with told us that the staff knew how they wanted to be supported and that they made sure they got what they needed. We asked the same person what they thought of the quality of care and they said, “They treat me OK.”

People told us that they were included when their care plan was written and were given an opportunity to read it before it was finalised.

Records showed that staff were recruited properly, with all necessary safeguarding checks being done. We spoke with three staff members who told us that they received supervision and that they felt that they received sufficient training to enable them to do their job effectively. We found evidence that the organisation had systems in place to monitor the quality of care the service provided.