Royal Mencap Society - Norfolk Domiciliary Care Agency

The service had been under tremendous strain particularly considering the impact of the COVID-19 pandemic. Despite this, staff and the management team had pulled together to ensure people's commissioned hours were provided. Staff reported occasionally working with less staff than they needed but said this had minimal impact on people's support needs.

Record keeping was not up to date and audits to assess the quality and safety of the service as a whole were not as regular or sufficiently robust. There had been a reduction in management hours. This was due to service managers and support workers with additional responsibilities working shifts and not being able to always complete their other administrative tasks. Some documentation particularly in relation to people's mental capacity and how staff should act in their best interest if deemed not to have full capacity was not clearly documented.

People's records had been transferred on to a new digital platform but not all records had been scanned in which made it difficult to case track both people and staff records. The new systems were being embedded but we found no one using the service had been given access to their records or being asked to regularly contribute to a review of their needs.

Staff had access to regular digital training mostly online as face to face training had not been safe to deliver during the pandemic. There were suitable arrangements in place to support new staff, but we found spot checks were not happening and supervision of staff varied in quality and frequency across the different sites. Staff expressed concerns about developmental opportunities as supervisions were not used to set objectives and review staffs training needs. The registered manager explained a new staff development tool was being introduced. We have made a recommendation about staff training.

There was insufficient oversight of staff practice in relation to their infection control practices. feedback was not regularly sought about how to improve the quality of the service.

Records did not demonstrate how people were supported to make appropriate choices in line with their

preferred communication preferences. People's ability to understand decisions had not been fully considered in line with their needs. The service had not fully considered people's needs and preferences in relation to the care and treatment as they aged. We have made a recommendation about this.

Staff understood their needs and interests. People had varied opportunities to go out and do things they enjoyed. Staff valued people and ensured they maintained contact with friends and family.