Archived: Adult Learning Disability Team

Adult Learning Disability Team provides community based services and care management for people with learning disabilities within Bedford Borough. They perform a number of different roles which do not fall within the scope of registration with the Care Quality Commission (CQC). They are however registered with the CQC for the treatment of disease, disorder or injury. This allows their team of learning disability nurses to go to people with learning disabilities living in the community and administer a regular depot injection. At the time of this inspection, the service was administering depot injections for five people.

The service had a registered manager. 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.

People received care from staff that were aware of abuse and had received training in safeguarding people against abuse. There were systems in place to report suspected abuse and staff were familiar with the procedures they had to follow. Risks to people and the service had been assessed and control measures were put in place to minimise the impact of those risks. Staff were of suitable character to be performing their roles and had been robustly recruited. There were enough members of staff to meet people's needs. People's medication was given to them safely and appropriately, by trained members of staff.

Staff members had the training and support they needed to perform their roles. They were also able to access additional training, to help enhance the performance of the service. People's consent was sought by staff before providing them with their injections. Their wishes were respected and where people were unable to express their wishes or make their own decisions, the Mental Capacity Act 2005 (MCA) was used appropriately to make a best interests decision on their behalf. The service worked with people's other healthcare professionals to help ensure they received the care and treatment they required.

There were positive and mutually beneficial relationships between people and members of staff. These relationships were managed to prevent people from becoming dependent on one member of staff, ensuring they were comfortable with a number of different members of staff. People were involved in planning their care and were provided with information about the service in a format they could understand, such as easy-read versions of key documents. Staff members ensured they treated people with dignity and respect at all times.

People received person-centred care from the service. An initial assessment had been completed at the start of the care package to identify people's specific needs and wishes. This was used to create a care plan which was regularly reviewed to ensure it continued to meet people's changing needs and wishes. Complaints and feedback from people was encouraged and the service had systems in place to ensure feedback was used to develop the service.

The service had an open and positive culture. Staff members were empowered to perform their roles and were well supported by the registered manager and provider. The registered manager ensured regulatory requirements were being met and, together with the provider, carried out a number of checks and audits. These were used to monitor the service and identify areas for improvement.

We found the provider had taken steps to improve their staff recruitment processes, to ensure that people received their treatment from suitably qualified staff, who were registered with the Nursing and Midwifery Council (NMC). Staff were also supported to acquire additional training, in order to continue to provide effective treatment to people who used the service.

The provider had effective systems in place to assess and monitor the quality of the service they provided. We found they regularly assessed and managed risks relating to the health, welfare and safety of people who used the service.

Support plans and needs assessments showed that people were involved in the development of their support plans. This was confirmed in the discussion we had with the person using the service.

The recruitment process was robust and all files we looked at contained the necessary employment checks.

There were effective systems in place to regularly assess and monitor the quality of service that people received and to enable people to express their views about the service.