One to One Plus South

Updated 22 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 30 January 2019 and was announced. The inspection was carried out by one inspector. We gave the service 48 hours notice of the inspection visit because we needed to make arrangements to visit people in their own homes and to ensure staff would be at the provider’s office.

Before the inspection we checked information that we held about the service provider. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we visited one of the supported living services where two people lived. We spoke to one of these people. We spoke to the relatives of four people. We visited the provider’s office. We spoke with two care staff, an assistant manager of a supported living service, four members of the management team and the registered manager. We sent survey questionnaires to people, their relatives, staff, and health and social care professionals to ask them to give us their views of the service; we received completed surveys from six people, 22 staff and one health and social care professional. We also received feedback from another health and social care professional and a contract commissioning officer from a local authority.

We looked at the care plans and associated records for four people. We reviewed other records, including the provider’s internal checks and audits, staff training records, staff rotas, accidents, incidents and records of medicines administered to people.

Updated 22 February 2019

The inspection was announced and took place on 30 January 2019.

One to One Plus South provides personal care and support to people in their own homes. Personal care and support is provided for people living with a learning disability or autism. At the time of the inspection personal care and support was provided to 23 people in seven supported living services, which are houses privately rented by people. The supported living services are staffed over a 24-hour period and people are supported with social care needs such as, activities and occupation, as well as their personal care. The Care Quality Commission inspects the care and support people receive in supported living homes, but does not inspect the accommodation people live in.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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 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. There was, however, a lack of clarity in care records regarding consent to care and treatment and when best interests decisions were made on behalf of one person whose liberty was restricted for their own safety. Staff were not clear about the correct procedures they needed to follow to ensure legal safeguards were followed when people did not have capacity to consent and where their liberty was restricted. We have made a recommendation about this.

Medicines were safely managed.

Staff had a good awareness of the importance of protecting people and what to do if they considered people were not being treated appropriately. Risks were assessed and there were procedures for care staff to follow to ensure people were safely supported. Sufficient numbers of staff were provided to meet people’s needs. Checks were made on the suitability of new staff to work in a care setting. Staff were trained in infection control and had access to protective clothing to help prevent the spread of infection. The provider had a comprehensive system to review any accidents or incidents and when lessons could be learned.

Care staff were supported well and had access to a range of training courses including nationally recognised qualifications in care.

People’s nutritional needs were assessed and people were supported with food and drinks. Health care needs were assessed and the provider worked well with other health and social care services to ensure care needs were met.

Care staff treated people with dignity and respect. People were supported to make decisions about their care and support which promoted their independence. Care staff had a good understanding of the need to ensure people’s privacy was upheld. People and their relatives said they were very satisfied with the service. For example, one relative said, “We are very happy with the service. If I had to score it out of 20 I would give it 40.”

People’s needs were comprehensively assessed; this included assessments of people’s behaviour needs by the provider’s own behaviour consultant. Each person had care plans which reflected their needs, preferences and choices. Relatives told us the staff were responsive to people’s care needs and ensured person centred care was provided. People’s communication needs were assessed to a good standard and staff were trained and skilled in communicating with people.

Relatives said they had a good dialogue with the care staff and management team and felt able to raise any concerns or issues were always responded to.

The service was well-led and was responsive to the challenges it faced. The provider had systems to assess and monitor the quality of the service as well as plans to develop and improve. This included seeking the views of people, their relatives and staff about the quality of the service. Staff were supported to develop their skills and knowledge.

Further information is in the detailed findings below.