Archived: Somerset LD Services 3 Also known as The Links

Updated 23 September 2016

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 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 3 August 2016 and was carried out by one inspector. The provider was given 48 hours’ notice of inspection to ensure the registered managers were available to meet us and also to make arrangements for us to visit people in their own homes. The service is registered with the Care Quality Commission (CQC) for the provision of personal care in people’s own homes.

Before the inspection we reviewed the information we held about the service. This included previous inspection reports, statutory notifications (issues providers are legally required to notify us about), other enquiries received from or about the service and the Provider’s Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.

The service was last inspected on 30 June 2014. At that inspection all quality and safety outcomes were compliant with the regulations. No concerns were identified at the previous two inspections either.

During this inspection we met with the service’s two registered managers, visited five of their shared occupancy houses, and spoke to 10 people who used the service and 17 staff. The staff included: team managers, assistant managers, support leaders, support workers and support assistants. Following the inspection, we telephoned eight more people who were supported by the domiciliary care teams and five domiciliary care staff.

We reviewed 2015/16 and 2016/17 ‘stakeholder feedback’ about the service from people’s relatives and professionals involved with people’s care. We also reviewed three people’s care plans and other records relevant to the running of the service, including: staff training records, medication records, complaints and incident files.

Updated 23 September 2016

This inspection took place on 3 August 2016 and was carried out by one inspector. The provider was given 48 hours’ notice of inspection to ensure the registered managers were available to meet us and also to make arrangements for us to visit people in their own homes.

The service is registered with the Care Quality Commission (CQC) for the provision of personal care in people’s own homes. This includes assistance or prompting with washing, toileting, dressing, eating and drinking. At the time of the inspection the service supported 94 people with a learning disability or autistic spectrum condition. This included 43 people supported by the Yeovil and Chard area network domiciliary care teams and 51 people in supported living shared occupancy houses. The shared occupancy houses supported by the service were: Churchmoor Farm; Rosedale; Orchardleigh; Bradley View; The Seasons; Vestry Road; Hillcrest Road; and Grove Avenue.

The service also provided other forms of social care support which are not included within CQC’s registration requirements for a supported living service. For example, in addition to personal care, the service assisted people with their housekeeping, shopping, attending appointments and other independent living skills.

The service provided people’s personal care and support under a separate contractual arrangement to people’s housing provision. People’s accommodation was provided by separate housing providers or landlords, usually on a rental or lease arrangement. This meant people could choose an alternative support service provider if they wished. Nevertheless, the service was happy to support people with reporting any faults or maintenance requirements to their respective landlords or housing association.

People who used the service had varying degrees of difficulties and support needs, ranging from mild to severe learning disabilities and autistic spectrum conditions. Some people had complex needs and required 24 hour support, whereas others were relatively independent and just needed assistance for a few hours each week.

There were two registered managers for this service. 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. The registered managers described the service philosophy as “The customer comes first. It is their home and not a work place” and “It is about providing support to individuals to meet their needs and aspirations. Person centred care, individualised as much as possible”.

People who used the service told us they felt safe and secure with the staff supporting them. A person who received support from the domiciliary care team said “They always give me the rotas and let me know who is coming. They all wear ID badges”. Another person said “They help me with my shower. I feel safe, no worries. They also do shopping with me. I know what they buy with my money and no one ever borrows or takes my money”. This showed people knew which staff were coming and when, which meant they were less vulnerable to unexpected callers or strangers. It also showed people were protected from financial abuse.

There were sufficient numbers of staff deployed to meet people’s individual needs and to keep them safe. Before people started to use the service, a detailed assessment of their needs was carried out. This included the staffing support required. Where people’s needs increased the staffing hours were increased. As people became more independent staffing support was reduced. All of the staff we spoke with told us the staffing levels were appropriate to meet the needs and choices of the people they supported. Staff also supported people to access external health and social care professionals when needed. Feedback from an external professional stated “I found that the team is very caring, reflective and receptive to new recommendations, which makes our collaborative work effective”.

Each individual service had its own team of regular staff. This ensured people were familiar with the staff who supported them and the staff understood their needs and preferences. Staff were available to support people with personal care when needed, but the service tried to encourage people to be as independent as possible. This boosted people’s confidence and self-esteem and enabled them to become more self-reliant.

Staff received individualised communication training to enable them to understand and communicate with people who had limited or no verbal communication skills. Where people lacked the mental capacity to make certain decisions the service ensured their human rights were protected.

All of the interactions we observed between people who used the service and the staff were friendly and caring. One of the people in a shared occupancy house said “We are all friends in the house”. A person who received support from the domiciliary care team said “They treat me lovely, nice and kind”. Feedback from people’s relatives included “I find the staff to be polite, patient and above all treat people with dignity and respect”; “Fantastic, attentive and caring staff”; and “Staff constantly go the extra mile”.

Systems were in place to ensure people received their prescribed medicines safely. Most of the people who received domiciliary care were able to self-medicate although occasionally they required assistance or prompting to take their prescribed medicines. Many of the people who lived in the shared occupancy houses had their medicines administered by staff, following a medicines risk assessment.

We found high levels of staff satisfaction across the whole service. Staff said the team leaders, team managers and the registered managers were all very accessible and supportive. The registered managers were visible and visited each service on a regular basis. The service was facing a major transition from local authority control to a new social enterprise company. Staff told us they had been briefed about the future changes and, although this was obviously unsettling, the majority were hopeful and optimistic about the future direction.

The provider had an effective quality monitoring system to ensure standards of service were maintained and improved.