Look Ahead Domiciliary Care (Hertfordshire)

Look Ahead Domiciliary Care (Hertfordshire) is a supported living service providing personal care to people living in their own homes. The service provides support to people with a learning disability and autistic people. At the time of our inspection, there were 19 people using the service, 15 people received the regulated activity.

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 Care Quality Commission (CQC) to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The service met this guidance.

We spoke with 13 staff members. This included support workers, managers and senior leaders. We got feedback from professionals that supported people living at the service.

At the last inspection, we found a breach in keeping people safe from harm and abuse and governance. We issued 2 warning notices which outlined actions to take to improve people’s care. This assessment was triggered to review the warning notices. We found at this assessment that both warning notices were met, and the provider was no longer in breach of regulation.

The service demonstrated a positive and proactive culture of safety, with openness, learning, and accountability clearly embedded in practice. Staff understood how to recognise, report and respond to incidents and safeguarding concerns, and timely action was taken to help keep people safe. Risk assessments were person centred and regularly reviewed to promote independence while managing risk, including physical and emotional wellbeing. Since the last inspection, leaders had reflected on restrictive practices and ensured these were reviewed, justified, and aligned with the Mental Capacity Act 2005 ‑and least restrictive principles.

People received care in safe, well managed‑ environments, supported by sufficient numbers of skilled and competent staff. Recruitment processes were robust, and staff received regular training, supervision and support tailored to the needs of people using the service. Medicines were largely managed safely, and any identified gaps in staff knowledge were addressed promptly through management action. Infection prevention and control required further improvement to ensure risks were assessed and managed consistently across all environments; however, staff demonstrated awareness of risks and took appropriate action when concerns arose.

The service was well led, with compassionate, approachable leaders who promoted openness, inclusion and a shared sense of purpose. Staff felt supported, valued, and confident to raise concerns, and feedback was used to inform improvement. Governance systems provided oversight through audits, checks and learning from incidents, although further work was needed to fully embed registration and governance arrangements across all services. The provider worked effectively with partners and the wider community and demonstrated‑ a strong commitment to continuous learning, collaboration and improving outcomes and quality of life for people supported.