The DOVE project is domiciliary (home care) service and supported living service providing personal care to 13 people in Plymouth and surrounding areas. The service was registered to provide domiciliary care and supported living. Domiciliary care services provide personal care to people living in their own houses and flats in the community. No one was in receipt of this service at the time of the inspection. This service also provides care and support to people living in ‘supported living’ settings, so that they can live in their own home 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 DOVE project provides personal care to older and younger people with learning disabilities and people with physical disabilities. Some people had additional services offered by the provider including domestic, recreational and companionship help.

This inspection took place on 12, 13 and 16 March 2018. Five days notice was given as the service is small and we needed to be sure the manager would be available when we visited the agency offices. This time also enabled the manager to arrange home visits. This allowed us to hear and observe people’s experiences of the service. The people we met were supported by staff 24/7 and had limited verbal communication skills.

At the last inspection in January 2016, the service was rated Good. At this inspection we found Effective, Responsive and Well Led required improvement.

In June 2017, Selborne Care Limited was purchased by Care Tech. The registered manager left in November 2017. A new manager had been appointed in November 2017and was in the process of applying to be the registered manager. 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.

The new management team were in the process of updating the governance systems and identifying the areas which required improvement. They were motivated and positive about the future and had good ideas for developing the service. However, we found areas across the inspection that required improvement including better analysis of people’s behaviour, implementing regular reviews and improving recording of people’s goals and aims. The manager and provider promoted the ethos of honesty and admitted when things had gone wrong. They were keen to address the findings of the inspection quickly and sent an action plan promptly following inspection feedback addressing all areas identified within the report.

People’s human rights were protected. However, a better understanding and recording of the code of practice in relation to the Mental Capacity Act 2005 (MCA) was required. People’s nutritional needs were met because staff followed people’s support plans to make sure people were eating and drinking enough and potential risks were known. However, where people lacked consent to agree healthier meals were in their best interest, the documentation to support these decisions was lacking.

Policies and procedures across the service required improvement to ensure information was given to people in accessible formats when required, for example the service user guide, complaints information, and support plans.

People’s care was not always responsive to their needs. There was a lack of evidence to demonstrate people’s and if appropriate, their relatives or advocates involvement in regular reviews of people’s support plans and goals. These processes help ensure people’s individual needs and preferences are known, shared and planned for. Support plans were personalised and guided staff to help people in the way the

We spoke with the manager, three coordinators, two team leaders and a new member of staff. We also spoke with and met people using the service.

People we spoke with told us they were very happy with the service they received from the agency and they were enjoying their lives. One person told us "I love it in my own home. I like holidays and do so much I couldn't do that before". A member of staff told us that the person they cared for was “now attending a dance and music club and had been accepted by the wider community and being asked out to functions by them”. The staff member said “This had been a massive achievement for the client and it makes me so proud and happy to see their confidence growing”.

We saw that people had specific and individualistic care plans. These had been updated daily in accordance to people's wishes. Care plans were easy read with pictures and colour coded charts. This demonstrated an awareness of the individual persons understanding and abilities to read and understand their own care plan.

Support staff worked at a level required by the individual and promotion of independence was evident. Staff had all received a thorough core training programme that included safeguarding and attended regular updates.

There were sufficient support workers to meet people's needs and appropriate background checks had been completed on all staff. Audits were in place to continually monitor and assess the quality of care and support provided.

The inspection took place on 11 and 12 November 2015 and was announced. The provider was given 48 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.

The D.O.V.E Project is a Domiciliary care agency providing personal care and support to people with a learning disability who live in their own homes. On the day of the inspection twelve people were supported by The D.O.V.E Project with their personal care needs.

The service had a registered manager in post. 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.

On the day of the inspection staff within the office were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.

People spoke highly about the care and support they received, one person said, “Staff are all really lovely and caring”. Care records were personalised and gave people control over all aspects of their lives. Staff responded quickly to people’s change in needs. People or where appropriate those who mattered to them, were involved in regularly reviewing their needs and how they would like to be supported. People’s preferences were identified and respected.

Staff put people at the heart of their work; they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed and practice was person focused and not task led. Staff had full appreciation of how to respect people’s individual needs around their privacy and dignity.

People’s risks were managed well and monitored. People were promoted to live full and active lives. Staff were highly motivated, creative in finding ways to overcome obstacles that restricted people’s independence.

People medicines were managed safely. People received their medicines as prescribed, on time and understood what they were for. People were supported to maintain good health through regular access to health and social care professionals, such as GPs, social workers, occupational therapists and physiotherapists.

People told us they felt safe. Comments included, “I definitely feel safe” and “I feel very safe and secure”. All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were supported by staff who confidently made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected.

People were supported by staff teams who had received a comprehensive induction programme, and tailored training that reflected their individual needs. A health care professional commented, staff were very effective at carrying out what they had learnt, and followed advice with skill and enthusiasm.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

The service had a policy and procedure in place for dealing with any concerns or complaints.

No written complaints had been made to the service in the past twelve months.

Staff described the management to be supportive and approachable. Staff talked positively about their jobs. Comments included, “I love my job, it’s both challenging and rewarding and I love it”, “It’s different every day, I get so much enjoyment from making a difference. I know what I need to do and I have the right tools to do it, I love my job” and, “It is a real family atmosphere here, everyone is motivated to do well for the people and each other”.

There were effective quality assurance systems in place. Incidents of concern were appropriately recorded and analysed. Learning from incidents and concerns raised were used to help drive improvement and ensure positive progress was made in the delivery of care and support provided by the service.