Date of Assessment: 27 March to 15 April 2025. The service is a care at home service providing support to adults living with learning disabilities. At our last assessment the service was rated requires improvement. We asked the provider to take action to address concerns we raised in relation to consent to care and treatment and governance. At this assessment we found the service had taken appropriate actions to address these issues and were no longer in breach of regulation. The provider had improved their rating to good. The provider had a good learning culture and people could raise concerns. The management team investigated incidents thoroughly. Risks associated with people’s care and support were identified and action taken to mitigate them. Staff were recruited safely and completed training to ensure they had the skills to carry out their roles. The management team supported staff through regular one to one sessions and appraisals. People received their medicines as prescribed. People were involved in planning and reviewing their care. Staff assisted people to meet their outcomes and ensured people were at the centre of their support. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
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Date of Assessment: 27 March to 15 April 2025. The service is a supported living service providing support to adults living with learning disabilities. At our last assessment the service was rated requires improvement. We asked the provider to take action to address concerns we raised in relation to consent to care and treatment and governance. At this assessment we found the service had taken appropriate actions to address these issues and were no longer in breach of regulation. The provider had improved their rating to good. The provider had a good learning culture and people could raise concerns. The management team investigated incidents thoroughly. Risks associated with people’s care and support were identified and action taken to mitigate them. There were enough staff with the right skills, qualifications and experience. Staff received appropriate training, and the management team supported staff through regular one to one sessions and appraisals. Staff managed medicines well and involved people in planning any changes. People were involved in planning their care and set goals they wanted to achieve. Staff assisted people to meet their outcomes and ensured people were at the centre of their support. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
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Doncaster Community Support received an overall rating of Requires Improvement following its October 2023 inspection, with regulatory breaches identified under Regulation 11 (consent/MCA) and Regulation 17 (good governance). While the service demonstrated kind, person-centred care and safe practices in many areas, significant failings in Mental Capacity Act compliance, inconsistent staff supervision, inadequate staffing levels for community access, and ineffective governance systems undermined overall quality.
Concerns (8)
criticalConsent / capacity: “Assessments of people's capacity to make specific decisions, for example on medicines or mechanical restraint, had not always been completed and best interest meetings had not been arranged in line with MCA principles.”
criticalGovernance: “The provider's governance systems were not always effective...they had failed to identify the concerns we found at inspection in relation to the Mental Capacity Act, staffing levels and staff supervisions.”
moderateSupervision / appraisal: “Supervisions were not consistent across the service...Comments from staff included, 'We have nothing official' and, 'There is nothing documented'.”
moderateStaffing levels: “There were not always enough staff on duty to provide 1-1 support for people to access the community or attend medical appointments...community leave and medical appointments were often cancelled.”
moderateRecord keeping: “Records were not always accurate, up to date or contain relevant information...a person's support plan still contained information they required pressure care on a daily basis, this was no longer the case.”
moderatePerson-centred care: “People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests.”
minorCommunication with families: “People and their relatives were not fully engaged with the running of the service. Relatives told us they did not attend regular meetings with other families and did not get asked for feedback.”
minorCare planning: “Support plans contained information that did not always relate to a person's care. For example, medication support plans contained information about the systems and processes of ordering medication.”
Strengths
· People received kind and compassionate care from staff who used positive respectful language.
· Safe recruitment and selection processes were followed with all necessary pre-employment checks.
· Risks to people's safety and welfare were assessed appropriately with plans in place to minimise risk.
· Accident and incidents were analysed for themes and trends, with learning shared with staff.
· People received their medication as required with appropriate 'as and when required' guidance.
Quality-Statement breakdown (22)
safe: Staffing and recruitmentGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the law
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Requires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: How the provider understands and acts on the duty of candourGood