This inspection was announced and took place on the 14, 16 and 20 December 2016.Care Opportunities Supported Living provides care and support for individuals with learning and physical disabilities living in their own homes. At the time of the inspection the service was supporting 12 people.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff and the management team had an excellent understanding of managing risks and were supporting people to reach their full potential. Staff and the management also helped people to overcome difficulties resulting from people’s past experience and anxieties. People felt safe in the service and staff had a very clear understanding of their responsibilities in relation to abuse. The provider's whistleblowing policy protected staff to make disclosures about poor staff conduct or practice, and staff confirmed the manager would take responsive action if they reported such problems.
People had their medicines managed safely, and received their medicines in a way they chose and as prescribed.
The provider had effective recruitment and selection procedures in place and carried out relevant checks when they employed staff to help ensure staff were suitable to work with vulnerable people.
People’s rights were recognised, respected and promoted. Staff had a good understanding of the Mental Capacity Act 2005 and we saw people’s consent was sought routinely. Staff were knowledgeable about the rights of people to make their own choices. This was reflected in the way the care plans were written and the way in which staff supported and encouraged people to make decisions when delivering care and support.
The provider and the registered manager were highly committed to encouraging staff to participate in training to develop their skills. Staff were provided with a range of training opportunities. The registered manager used creative, proactive and innovative ways of enhancing the skills of staff. This enabled staff to apply their learning in their practice. Knowledge tests were created with respect to people’s support needs and used to consistently check the staff members’ knowledge. This helped to ensure staff delivered, personalised, quality care.
Staff told us they felt supported by the management and received supervision and appraisals, which helped to identify their training and development needs.
People's health and well-being needs were monitored. The registered manager and staff responded promptly to any concerns in relation to people's health and were knowledgeable about people's medical history. Staff always accompanied people to hospital appointments and visited them in hospital. People were supported to maintain a healthy, active lifestyle. Clear, easy-to-read plans were designed to help people manage health conditions that needed monitoring. Health and social care professionals were involved in people's support when needed and their advice was included in the care provided. Staff worked together with community professionals to prepare people for health care checks.
The interactions we observed between people and staff were positive. We heard and saw people laughing and smiling. People looked comfortable, relaxed and happy in their home and in the company of other people they lived with.
The difference the service was making to people's lives was apparent. Some of the people had previously displayed anxious behaviour or had been emotionally disturbed which had led to restrictive lifestyles. However, the service now supported them in a more positive way. People needed consistent support to make them feel secure and understood, to manage their behaviours and to make their needs known. During the inspection we observed people receiving this. The warmth of the relationships with each other and with staff, and the opportunities for new experiences enabled people to make positive progress.
The service provided excellent care and support to people enabling them to live fulfilled and meaningful lives. Activities and people's daily routines were personalised and tailored to people's particular choices and interests. People were supported to develop their skills and pursue their hobbies and interests. People benefited from consistent support, good teamwork of staff, good planning and delivery of person-centred care. For example, the service had managed to reduce one person’s anxiety levels and built up their confidence so that the person was able to travel to another country by plane. It was something this person had not been able to consider and cope with before. The person spoke excitedly about their forthcoming holiday and staff talked enthusiastically about the planning, preparations and the reasons why the person had chosen their destination.
People were able to express their opinions and were encouraged and supported to have their voice heard. People were fully involved in planning and reviewing their care and support needs.
There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.
There was a positive culture within the service, the management team provided strong leadership and led by example. The registered manager promoted values of high quality, person-centred care and had clear visions of how they wished the service to be provided. The manager’s enthusiasm helped to make the whole staff share these values. Individualised care was central to the home's philosophy and staff demonstrated they understood and practiced this by talking to us about how they met people's care and support needs.
The provider had a robust quality assurance system in place and gathered information about the quality of the service from a variety of sources including people who used the service and other agencies. Learning from incidents and feedback were used to help drive continuous improvement.