Archived: Borough of Poole - Supported Living Service

• People’s experiences had improved significantly and they now received outstandingly effective, caring and responsive care and support from an exceptionally well led and constantly improving service.

• People consistently told us how they were treated with exceptional kindness, compassion and respect. We received overwhelmingly positive feedback on how staff were supportive and everyone we spoke with praised the service they received. Comments from people and relatives included; “I consider myself the luckiest man ever”, “I feel better about myself. I’ve got things I can do and I’m really busy all the time. I never got out of bed before. My life has improved…This makes me feel able instead of disabled”, and, “I can’t tell you how much her life has improved over the last 12 months.”

• People and staff described how the service made them feel respected, valued and listened to. Respect for privacy and dignity was at the heart of the service's culture and values.

• People were supported to have maximum choice and control of their lives and supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• People received exceptionally personalised care and support specific to their needs and preferences. People had had the opportunity to choose their own staff and ensure that they were compatible. Each person was respected as an individual, with their own social and cultural diversity, values and beliefs.

• 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 now stable which meant that people had achieved positive outcomes, exceeding their own and others, previous expectations.

• The service was exceptionally well-led. The registered manager demonstrated how their open and listening management style and robust quality assurance systems had sustained continual development and improvement at the service. They had demonstrated ways of working that ultimately improved the outcomes for people they supported. They were clear about their expectations relating to how the service should be provided and led by example. Since the last inspection, they had made many positive changes and were driven to provide an outstanding service. They were supported by a staff and a senior team who were passionate and fully committed to delivering quality person-centred care to people. Staff were motivated by and proud of the service and morale was very high within the service.

Rating at last inspection: GOOD (The date last report published was 13 May 2017).

About the service: Borough of Poole supported living service provides personal care and support to adults with learning disabilities living in their own homes.

Why we inspected: This was a planned inspection based on the rating at the last comprehensive inspection. The service has improved and has now been rated Outstanding.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Outstanding.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

At the last inspection in August 2016, overall the service was rated Good but Well-led was rated requires improvement.

This was an announced focused inspection on 27 April 2017 to follow up on the actions taken to address the breach of regulation in relation to the governance of the service. This was because at the last inspection the previous registered manager had not been at work for a period of time and governance procedures had not been followed. Where concerns had been raised about the quality of service these had not always been acted upon. This meant the quality of service people received could not be assured.

At this inspection there were significant improvements in the governance of the service. Staff spoke highly of the new registered manager and the changes that had been implemented. All actions included in the registered manager and provider’s action plan had been met. The service was now well-led and there was an open, inclusive and person centred culture.

At this inspection we changed the rating for the key question ‘Is the service well-led?’ from Requires Improvement to Good. The overall rating for the service remained Good.

Further information is in the detailed findings below.

At the time of the inspection there was 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. However, the registered manager was away at the time of the inspection and had not been in post for an extended period of time. Instead, we were supported by two senior care staff and a service manager.

Recruitment practices were robust and medicines were managed safely to ensure people received their medicines as prescribed. We made a recommendation about the management of accidents and incidents.

People were supported to make decisions and their rights were protected when they lacked mental capacity to make a specific decision. People were supported to maintain their physical well-being and saw healthcare practitioners as and when they needed to.

Our observations showed people were treated with kindness and compassion in their day-to-day care. We asked people what was the best thing about the service. One person said, “My friends” and a member of staff told us, “They are so well looked after; when they go out they always want to come home”.

Staff knew the people they were caring for and supporting, including their preferences and personal histories. This meant they were better able to form good relationships and support people in the way they wanted or needed to be supported.

People had support plans that reflected their personal history, individual preferences and interests. Staff had read people’s support plans and used the information to make sure they helped the individual in the way they wanted or needed to be supported. We made a recommendation about the management of complaints.

The registered manager had not been in post for a period of time and governance procedures had not been followed. Where concerns had been raised about the quality of service these had not always been acted upon. This meant the quality of service people received could not be assured. You can see what action we told the provider to take at the back of the full version of the report.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People we spoke with were happy with the support they were received from staff. One person told us, 'Staff are really nice', and a member of staff also told us, 'You get a lot of one-to-one time with people'.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

The provider had an effective system in place to regularly check and monitor the quality of the service people received.

We used a number of different methods to help us understand the experiences of people who used the service. This was because some of them had complex needs which meant they were unable to tell us about themselves.

We spoke with two people, observed care workers supporting four people and spoke with two senior care support officers and five care workers. The manager was not present during the inspection.

We observed that care workers and people were relaxed with each other; they laughed and enjoyed each others company. Some people actively sought the company of care workers.

One person Makaton (a type of sign language) signed that they were 'happy' and 'liked' staff. Another person said that they liked the flat they lived in and got on well with staff.

We saw that care workers knew each person's likes and dislikes and had good relationships with the people they cared for. They understood how people communicated and responded to people's non verbal cues and gestures.

We spoke with staff who understood what safeguarding was and what they would do if they suspected someone was being abused. Staff told us that they had staff meetings, handovers and support meetings with their line manager.