Stepping Stones to Independence

Updated 5 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 31 May and 1 June 2017 and was announced. We gave notice of our inspection to ensure key people would be available at the service when we visited. The inspection team consisted of one inspector.

Prior to our visit we asked for a Provider Information Return (PIR). The PIR is information given to us by the provider. The PIR also provides us with key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service. This included notifications we had received from the service. Services use notifications to tell us about important events relating to the regulated activities they provide.

Four health and social care professionals were contacted in order to gain their views about the service. Two of them provided feedback about the service.

We looked at the care records of four people, the recruitment and personnel records of three staff, training records, staff schedules and other records relating to the management of the service. We looked at a range of policies and procedures including, safeguarding, whistleblowing, recruitment, mental capacity and complaints.

We spoke with three people on the phone that were supported by the service and two relative’s. We tried to contact a further four people by phone but we not successful. We spoke with three care staff, one care coordinator, the training manager, operations manager, nominated individual and the registered manager.

Updated 5 August 2017

The inspection was announced and took place on 31 and 1 June 2017. We gave the provider 48 hours’ notice of the inspection. We did this to ensure key staff would be available at the service. At the time of the inspection the service was providing personal care to 40 people living in their own homes.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

At the time of the inspection the service employed, a registered manager, operations manager, training manager, two care coordinators, two field supervisors and care staff.

People felt safe and there were systems in place to safeguard them from risk of possible harm. People had individual risk assessments so that staff had the information they needed to support them safely and minimise the identified risks.

People's medicines were being managed safely and administered by trained staff. People spoke

highly of the staff that provided their care and people’s relatives were also complimentary of staff. Staff we spoke with demonstrated they were aware of people’s individual needs and understood their preferences.

Staffing levels were sufficient to meet people’s needs and protected them from harm. The service carried out pre-employment checks on staff before they worked with people to assess their suitability.

Staff received regular supervision to discuss their progress and training needs. Spot checks were completed by senior staff to monitor staff performance and ensure people were receiving support in line with their needs and expectations.

Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. Staff had a good understanding of people's needs and supported them effectively. People and relatives told us that staff were respectful of their homes and supported them to maintain their independence.

Staff were described as caring, friendly and supportive. It was clear positive relationships had been built between people and staff. Communication between staff, people and their relatives was positive.

People's needs had been assessed and there were care plans in place that took account of their individual needs, preferences, and choices. The service had had an effective system in place to manage complaints.

People received a service that was well-led because the registered manager provided good leadership and management. Systems were in place to check on the standards within the service. These included regular audits of care records, recruitment files, risk assessments, health and safety, staff training and supervision.