PALS Ltd

Updated 10 December 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

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency, providing personal care to people living in their own homes. 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.

The service provides wide-ranging support and training in addition to the personal care provided to the two people reviewed during this inspection. At the time of our inspection, the service was working with nearly 100 people, whose support was not covered by our report.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection and we could arrange to meet with the people and their relatives. We visited the office on 24 October 2019.

What we did before the inspection

Prior to the inspection we gathered and reviewed information we held about the service, including information we had received from the provider. 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 and plan our inspections.

During the inspection

We met with two people who used the service, their relatives and the staff who supported them.

We met or spoke with two members of care staff, one senior care staff, the registered manager and one of the directors of the organisation. We reviewed a range of records, including two people's care records. We looked at information relating to the management of the service, including staff files and quality audits.

After the inspection

The registered manager sent us information which we had requested. We had contact with four health and social care professionals who had contact with this service. Four relatives of people not included in the inspection contacted us to provide feedback on the service.

During our inspection we became aware an administrative change was needed to ensure the organisation’s registration certificate held the right information. The provider readily submitted the necessary paperwork when requested and the revision was completed prior to the publication of the final report.

Updated 10 December 2019

About the service

PALS Ltd provides support and personal care to people with learning disabilities, autism and other needs, in the community. This report refers to the care and support provided to people who received personal care in their own homes. Personal care is help with tasks related to personal hygiene and eating. At the time of the inspection, two people were receiving support with their personal care within their home on an adhoc basis. The service responded flexibly to people’s changing needs and circumstances and had the capacity to provide personal care to other people in their homes, if required.

People’s experience of using this service and what we found

The registered manager was an inspirational leader. They told us before the inspection, “We actively encourage person centred approaches in all aspects of our service.” Our findings confirmed this was an ethos which ran through the whole organisation. Feedback from people, families, staff and professionals about the service was universally positive.

A key theme throughout the inspection was the cherished relationship between care staff and the whole family of the person they supported. There was an intensive process which matched each person to a small caring staff team who knew them well and had been selected specifically to meet that person’s individual needs and preferences.

Staff were skilled at meeting people’s needs safely, enabling them to be part of their local community. The service provided flexible opportunities for staff to develop their skills, so they were able to meet the needs of the people they supported. People’s health needs were mainly supported by families and other professionals, with staff providing support to enhance their wellbeing.

Senior staff had assessed people’s needs and produced written guidance for care staff. This guidance did not always reflect the person-centred support people received. This did not impact on the safety or on the quality of the support people received due to excellent communication, and the detailed matching and shadowing process. We discussed the quality of care records with the registered manager and they agreed to review their process to ensure staff had the required information, particularly for people with more complex needs.

The service applied the principles and values of Registering the Right Support and other best practice guidance 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.

There was scope to improve some of the more formal quality checks. However, the commitment and involvement of the senior staff team meant they had a deep understanding of what was happening at the service. The registered manager promoted open communication with people, families, staff and professionals. This created a service which adapted flexibly to people’s needs and in response to feedback.

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

Rating at last inspection

This is the first inspection for this service. Although the service was registered in 2011, they have not always been providing personal care during this period.

Why we inspected

This was a planned inspection to check the quality of the service.