Lancaster & Morecambe Domiciliary Service

Lancaster and Morecambe Domiciliary Service is part of Lancashire County Council and provides supported living services to people with learning disabilities and autistic people, living in their own homes. At the time of our inspection there were 59 people living in 19 different tenancies.

We assessed the service against ‘Right support, right care, right culture.’ This guidance supported judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choice, independence, and access to local communities that most people take for granted. We found the service had demonstrated a clear understanding of this guidance and had met the requirements of these principles.

People were supported to be safe. The providers safeguarding policies and procedures had been understood and followed by staff. People were supported to manage risks to their safety, health and wellbeing. We found some improvement was needed to ensure some risks were identified in a timelier manner. We were assured this had been addressed prior to and during this inspection. People were supported to transition into the service safely and when they needed to go to hospital. Staff stayed with people when they were waiting at accident and emergency department and provided support when people were admitted to hospital.

Staff were recruited properly and received training appropriate to their roles. People received their medicines as prescribed from trained and competent staff. People's homes were clean and staff followed clear infection prevention and control procedures.

People received effective care because the provider ensured people's needs had been properly assessed, reviewed and updated. Pre-admission assessments were overseen by the registered manager who ensured they were comprehensive and provided effective guidance for staff. Staff were skilled and knowledgeable about people's needs and how they preferred to be supported. Care records included information from a range of sources, including the person, their relatives and guidance from other professionals involved. The staff team worked well together and were committed to providing effective care. People were supported to achieve optimum health. Staff and leaders were proactive in supporting people who found medical treatment challenging to accept. People's rights were respected, and they were involved in decisions about their care and important events. Where people were not able to give their consent, the provider ensured proper legal authority had been sought. Any restrictions in place had been reviewed regularly to ensure people experienced the least restrictive support.

Staff were kind, caring and compassionate. People were respected as individuals and their unique qualities and talents were recognised and supported by staff. People were encouraged to be independent and to have choice and control. Staff felt well supported at work and praised the compassionate support they received from leaders.

People received good-quality person-centred care. Staff and leaders regularly reviewed and updated care plans which included details of the person's life experiences, culture and preferences. People were supported to express their views, and their concerns had been responded to. Staff and leaders worked proactively to ensure people had equitable experiences and outcomes.

The provider, leaders and staff shared a clear value-based positive culture which fully embodied the principles of Right support, Right care, Right culture. People were supported to live fulfilling lives. Leaders helped embed good practice across the service. Staff praised their leaders’ skills and approachability. The providers policies and procedures in relation to oversight and governance were understood by leaders. We found some improvement was needed to ensure action was taken in a timely manner. We were assured this had been addressed.