Archived: Louise House

Positive Steps Shropshire is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. The service also provides domiciliary care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection 53 people were living in long-term shared lives arrangements, and 44 people accessed shared lives for respite only. There were 26 people who received domiciliary care.

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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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’s experience of using this service and what we found

We saw excellent examples of how people were supported to remain safe at times when they were at significant risk. The risk of abuse was minimised because there were clear processes, training and procedures in place to protect people. Staff and SLC were proactive and supported people to take positive risks, ensuring they had maximum choice and control of their lives.

The provider's robust recruitment processes for staff and SLC, along with the matching process, had exceptionally positive outcomes for people.

Medicines were managed safely. There was an open and transparent culture in relation to accidents and incidents and they were used as opportunities to learn and lessen risks.

Staff and SLC had exceptional skills and knowledge to deliver care and support in a person-centred way. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People's needs were met through robust assessments and support planning. We saw examples of when the service had worked with other professionals to achieve positive outcomes for people and to improve their quality of life.

People's privacy, dignity and independence was made a priority in supporting people in all areas of life. People could plan for their future, including their wishes at end of life.

People told us staff and SLC were exceptionally compassionate and kind. Staff and SLC expressed commitment to ensuring people received high-quality care. We heard excellent examples of how SLC ensured people felt part of their family. SLC and staff knew people exceptionally well. People were encouraged to learn new skills to enhance their independence.

We saw excellent examples of how the care and support people received enriched their lives through meaningful activities. The service was proactive in its response to concerns or complaints and people knew how to feedback their experiences.

The management team planned and promoted holistic, person-centred, high-quality care resulting in excellent outcomes for people. The values and culture embedded in the service ensured people were at the heart of the care and support they received. SLC and staff told us they received excellent support from management and staff told us they were extremely proud to work for the service. There was a very open and transparent culture and people were empowered to voice their opinions. Without exception, people told us the service was well-managed.

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

Rating at last inspection and update

The last rating for this service was good (published 18 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

This inspection took place on 7 and 9 September 2016 and was announced.

Positive steps Shropshire provides personal care for people as part of a shared lives and domiciliary care scheme. A shared lives scheme support a variety of different arrangements where families and individuals in local communities can offer accommodation and/or support for people. At this inspection they were providing care and support for 85 people.

A registered manager was in post and present during our inspection. 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 were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. Environmental risk assessments on individual properties were completed and actions undertaken to reduce the risks to people. Staff had access to care plans and risk assessments and were aware of how to protect people from harm.

The provider completed appropriate checks on staff before they started work to ensure they were safe to work with people. People received help with their medicines from staff who were trained to safely administer these and who made sure they had their medicine when they needed it.

People received care and support from staff that had the skills and knowledge to meet their needs. Staff attended training that was relevant to the people they supported. Staff received support and guidance from a management team who they found approachable. People had their rights upheld by staff who knew the appropriate legislation which directed their roles.

People’s likes and dislikes were known by staff who supported them in a way which was personal to them. People had positive relationships with the staff members who supported them. People had their privacy and dignity respected and information personal to them was treated with confidence. People had access to healthcare when needed and staff responded to any changes in need promptly and consistently. People were supported to maintain a diet which promoted well-being.

People were involved in decisions about their care and had information they needed in a way they understood. When people could not make decisions for themselves staff understood the steps they needed to follow to ensure people’s rights were upheld.

People and staff felt able to express their views and felt their opinions mattered. The provider and registered manager undertook regular quality checks in order to drive improvements. The provider engaged people and their families and encouraged feedback. People felt confident they were listened to and their views were valued.