Affinity Trust Domiciliary Care Agency East

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good overall, with the responsive domain being rated as outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This comprehensive, announced inspection took place on 10, 16, and 22 May, and 20 July 2018.

The care service has 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 learning disabilities and autism using the service can live as ordinary a life as any citizen.

People were supported by staff who were aware of their responsibilities in reducing the risk of harm occurring. Processes were in place to protect people from harm or poor care. Staff used equipment and technology to help promote people's independence safely. Staff were only employed after satisfactory pre- employment checks had been obtained. There were sufficient staff to ensure people's needs were met safely. Medicines were managed safely by trained and competent staff. The provider had effective procedures in place to support the prevention and control of infections. The provider had robust systems in place to manage accidents and incidents and lessons learned were shared across the organisation.

People's assessed needs were met effectively by staff who had the right training, knowledge and skills. Staff encouraged people to use technology to help keep them safe and promote their independence. People were enabled to access healthcare services and to eat and drink a healthy balanced diet and lead healthy lives. 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.

People were supported and cared for with compassion, empathy and kindness. Staff treated people with dignity and respect. Staff empowered people to make their own choices about things that were important to them. Staff encouraged people to maintain and maximise their independence. People had access to information that was available in alternative formats to enable peoples' understanding.

Staff supported people to maintain their links with the local community to promote and develop social inclusion. Staff used creative ways to help people maintain and develop their hobbies and interests. The registered manager and staff had an excellent understanding, and were very responsive to, each person's individual needs. Staff provided care that was person-centred and tailored to people's individual needs.

People's care arrangements took account of people's wishes and choices, including their likes and dislikes, what was important to them and any future goals. Staff were proactive in supporting people to develop and maintain relationships that were important to them.

People had access to the provider's complaints policy and procedure that was provided in an appropriate format to support people's communication needs. The provider had a process in place to receive and manage people's suggestions, concerns and/or compliments.

People had a say in how the service was run. People and their relatives were given opportunities to feedback on the quality of the service provided and felt listened to.

The registered manager provided good leadership. They and senior staff, made sure that the values of the service were embedded and promoted by staff. The provider's governance, quality assurance systems and audits were effective in monitoring that the service complied with legislative requirements and promoted best practice. Staff worked in partnership with other professionals to ensure that people received joined-up care.

Further information is in the detailed findings below.

The five questions we ask about services and what we found