Background to this inspection
Updated
3 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in three ‘supported living’ settings, so that they can live 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 2 August 2019 and ended on 9 August 2019. We visited the office location on 8 August 2019 and visited people in their homes on 9 August 2019. We contacted other people who used the service, their relatives, and staff by telephone on 6, 7 and 9 August 2019.
What we did before the inspection
We reviewed information we had received about the service since registration and we sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, senior service manager, service manager and support workers.
We reviewed a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
3 October 2019
About the service
Raglin Care Limited is a supported living agency that provides personal care and support to people living in their own homes. It provides support services to people with a range of needs such as physical disability, learning disabilities and autism. The service is located in Liverpool, and services are provided across Liverpool, Wirral, Sefton, Knowsley and St Helens.
Supported living is where people live either on their own or with a small group of others and have their own tenancy agreement. Care and support is provided in order to promote their independence. The care people receive in supported living settings is regulated by CQC, but the accommodation is not. The service supported some people on a 24-hour basis and others at specific times during the day and night. At the time of the inspection 49 people were being supported by the service with personal care tasks.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
There was a strong person-centred culture in the service. Staff empowered people to have a voice and realise their potential. People's individual needs and preferences were reflected in the way care was delivered. We saw multiple examples of how this had improved the lives of people being supported by Raglin Care.
Staff were highly skilled, motivated and knowledgeable. They provided flexible care and support in line with a person's needs and wishes. The staff team was consistent, and people achieved positive outcomes which exceeded expectations. People were able to live in their own homes, reduce social isolation and maintain personal or family relationships.
People were supported by a well trained staff team. Staff undertook comprehensive training tailored to each person being supported. Families were involved in the design and delivery of this training, ensuring people's needs were truly reflected and catered for. This enabled staff to deliver and maintain professional, high quality, person-centred care for people safely and confidently.
The leadership, governance and culture in the service was used to drive and improve the delivery of high-quality person-centred care. The management team had an inspired and shared purpose and fostered a culture of coproduction within the service that ensured people were active participants in their own care, and the delivery of the service. The inclusion of people in decisions about their care and the delivery of the service, had achieved excellent outcomes for people. People felt empowered and truly valued.
People had had the opportunity to choose their own staff and ensure that they were compatible. People told us being involved in the recruitment of staff had improved their well being and helped them in developing positive relationships. Family members told us they had full confidence in the staff and they were more like family to people. People and families told us the staff were kind, compassionate and respectful towards them. They described how they trusted and felt safe with them.
People were supported to engage with activities that interested them and supported with engaging in the community. It was clear staff knew what people liked to do and knew how to support them to avoid social isolation. We saw examples where people had been able to go on holiday for the first time, or spend time alone with loved ones for the first time. This had improved the well being of people supported by Raglin Care and their relatives.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support (PBS) principles. The use of PBS was highly effective in delivering positive outcomes for people. We saw evidence of the use restrictive interventions being greatly reduced.
Care plans focussed on individual goals and outcomes and contained detailed information regarding people’s likes, dislikes and preferences. People told us they developed good relationships with staff and staff knew them well.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Risks which compromised people’s health and well-being were appropriately assessed, reviewed when needed and contained detailed information. People told us they felt safe with the service.
Everyone we spoke with was complimentary about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 9 March 2017).
Why we inspected
This was a planned inspection based on our inspection programme.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.