Voyage (DCA) Warwickshire improved from Requires Improvement to Good across all five key questions following a follow-up inspection in November 2023, with all previous regulatory breaches (Regulations 12, 13, and 17) now resolved. The service demonstrated strong person-centred culture, effective medicines management, robust governance, and a well-supported staff team under improved management leadership.
Concerns (3)
minor
Care planning
: “some people were unable to access their written care plan and did not have an accessible format version.”
minorStaff competency: “One staff member, whose role included fire safety and first aid, did not have all the skills they needed in these areas when we asked about them.”
minorPerson-centred care: “We discussed one person's identified risk of physically responding to others where a few staff told us they did not always feel confident in managing this risk.”
Strengths
· All five key questions improved from Requires Improvement to Good since the last inspection, with no remaining breaches of regulation.
· Staff knew people well and demonstrated a caring, respectful approach; positive staff culture with valued, supported workforce.
· Robust recruitment checks, DBS verification, and reduced agency staff use providing greater consistency of care.
· Medicines management significantly improved with trained staff, competency checks, daily MAR audits, and prompt action on errors.
· Regular unannounced manager visits, weekly feedback meetings ('what is working and what is not working'), and effective governance audits.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff work with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood
Voyage (DCA) Warwickshire, a supported living domiciliary care agency for 41 adults with learning disabilities and complex needs, was rated Requires Improvement across all five key questions following its September 2022 inspection, representing a deterioration from its previous Good rating. Three regulatory breaches were identified covering safe care and treatment (Regulation 12), safeguarding from abuse including unlawful deprivation of liberty (Regulation 13), and governance failures (Regulation 17).
Concerns (15)
criticalMedication management: “Medicine stock discrepancies we found during our inspection meant we could not be assured people had always received their medicines as prescribed.”
criticalMedication management: “Stock discrepancies were found in one persons' controlled medicine.”
criticalSafeguarding: “In one shared home, all bedrooms were locked by staff and the kitchen had restricted access and cupboards were locked...we found no appropriate legal authority in people's plans of care.”
criticalCare planning: “Records showed one person was at significant risk of malnutrition due to very limited nutritional intake. It was not always clear what action had been taken to monitor and mitigate this risk.”
criticalGovernance: “Medication checks and audits had not identified the issues we found which meant actions had not been taken to ensure people always received their medicines as prescribed.”
criticalConsent / capacity: “We found some instances where restrictions were in place and people were being deprived of their liberty without the appropriate legal authority.”
moderateCare planning: “Assessment tools to identify risk were not always completed accurately. One person had been assessed as being at 'medium' risk of falls when they should have been assessed as 'high'.”
moderateStaff competency: “Whilst staff had completed training in the safe handling of medicines, safe practices were not always followed which had resulted in medication incidents.”
moderateStaff training: “Two staff members felt they needed training around learning disabilities, autism and managing specific behaviours.”
moderateGovernance: “Supported living shared home checks and audits were mostly delegated by the registered manager to field care staff...effective monitoring of the quality of the services did not always take place.”
moderateIncident learning: “The effectiveness of training and spot checks had not always been explored to determine if improvements were needed.”
moderateRecord keeping: “Care records, such as 'hospital passports', containing important emergency information were not always accurate or up to date.”
moderatePerson-centred care: “One relative told us, '[Name] loves to go outside, it is their favourite thing being out in the countryside, but staff don't always enable this to happen.'”
moderateLeadership: “Some relatives felt there was a lack of 'management presence' in some services and the lack of effective role modelling to staff impacted the quality of care.”
minorInfection control: “Some staff were seen wearing their facemasks under their nose or chin.”
Strengths
· Staff had a caring approach toward people, showing kindness in the hands-on day to day care.
· People and their relatives felt safe with staff in their homes and protected from the risks of abuse.
· The service understood the principles of STOMP; medicines were regularly reviewed with prescribers and reduced where appropriate.
· Pre-employment checks including DBS, identity checks and references were undertaken, ensuring safe recruitment.
· Some people had detailed Emotional and Behaviour care plans focusing on understanding the person and proactive responses.
Quality-Statement breakdown (25)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely care