Background to this inspection
Updated
19 July 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is 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 29 and 30 May 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that they would be in. The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed the information we held about the service, which included feedback from people about the service, information of concern and notifications since our last inspection. A notification is information about important events and incidents within the service.
We used information the provider sent us in February 2018 in the Provider Information Return (PIR). 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.
The inspection was informed by feedback from surveys completed by 11 people who used the service, a health care professional and 19 support staff. The responses and comments received were all consistently positive.
We contacted commissioners that monitored the care and treatment of people using the service and Healthwatch for their views about the service. Healthwatch is a consumer organisation that has statutory powers to ensure the voice of the consumer is strengthened and heard by those who commission, deliver and regulate health and care services.
We visited the office location to see the registered manager and office staff; and to review care records and policies and procedures. We spoke with nine staff in total. They included the registered manager, operations manager, office manager, supported living service manager and five support staff.
We spoke with a person who used the service who was involved in delivering staff induction training. We visited two people at one of the supported living accommodation. We spoke with three relatives by telephone to find out their views about the service. The expert-by-experience spoke with three people who used the service and a relative by telephone to find out their views were about the service provided.
We looked at the records relating to the care of five people, which included care plans, risk assessments and medicines. We looked at four staff recruitment records and a range of information that showed how the provider monitored the quality of service provided, which included audits, meeting minutes, surveys and a sample of policies and procedures.
Updated
19 July 2018
At the last comprehensive inspection on 25 and 28 October 2015 the service was rated 'Good'.
This is the second comprehensive inspection of the service. This inspection took place on 29 and 30 May 2018 and was announced. At this inspection we rated the service overall as ‘Good’.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people living with a learning disability and autistic spectrum disorder.
The service is divided into three areas; supported living, alternative day services and outreach support. This service provides care and support to people living in 10 supported living settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
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.
At the time of our inspection 35 people were receiving personal care and support. A registered manager is a person who has registered with the Care Quality Commission to manage the service.
A registered manager was in post. 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.
The management and staff team continued to demonstrate an outstanding commitment to providing a caring service which put people at the heart of everything. Staff were mindful of promoting people’s independence and respecting their privacy and dignity. People were supported to be actively involved in decisions about their care.
People were involved all aspects of their care. Risks to people had been assessed and managed, which took account of people’s preferences, diverse needs including those in relation to a person’s culture or belief. People were supported with their medicines and encouraged to take positive risks to promote their independence. People were supported to live healthier lives and were supported with their health care needs when required.
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. The provider, registered manager and staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and gained people's consent before providing their support.
Systems and processes were in place to safeguarding people from abuse; these covered staff recruitment practices and staff training and knowledge on safeguarding procedures. Staffing levels were kept under review to ensure people received sufficient staff support. Systems also ensured accidents and incidents were recorded and analysed and steps to improve and learn were identified.
Staff continuously provided the person-centred care and support people needed to ensure that people lived as fulfilled and enriched lives as possible. They respected people’s individuality and enabled people to express their wishes and make choices for themselves about their lives and aspirations. Staff had a good understanding of people's needs and preferences to ensure they were responsive. Positive relationships had been developed and staff were committed and passionate about promoting people’s independence and achieving positive outcomes for them.
People received care and support that enhanced their sense of well-being and quality of life because staff worked flexibly to enable people to have meaningful experiences and to become active members of the local community.
People, relatives and staff had opportunities to engage and be involved in the development of the service. People knew how to raise a concern or make a complaint and the provider had effective systems to manage any complaints they received.
The registered manager led and inspired the staff to deliver person centred care, which had achieved consistently outstanding outcomes for people. Systems and processes were in place to assess, monitor and improve the quality and safety of services. The service was focussed on achieving good quality outcomes for people using the service and worked in partnership with other health and social care professionals to ensure people received appropriate care.