NAS Community Services (North 2)

Updated 6 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection took place on 29 and 30 November 2017. We contacted the service two days before the visit to let them know we were inspecting. We did this because they provide a supported living service and we needed to be sure that someone would be available for the inspection. The inspection was carried out by one adult social care inspector.

Before the inspection, we reviewed the information we held about the service, including notifications and previous inspection reports. A notification is information about important events which the service is required to send us by law. We contacted the local authority contract monitoring team and had discussions with the local authority safeguarding team. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also sent questionnaires to staff and community professionals. We received five completed questionnaires from staff and two from community professionals. We used all this information to decide which areas to focus on during the inspection.

We used a number of different methods to help us understand the experiences of people who used the service. During the inspection we visited people in their own homes. We spent time with people and observed how they were supported. We spoke with three people who used the service. We also talked with three support workers, two deputy managers and the registered manager. We looked at a sample of records, including three care plans and other related documentation, three staff recruitment records, staff training records, records of complaints, policies and procedures and quality assurance records. Following the visit we had contact with the service’s area manager.

Updated 6 January 2018

This inspection was carried out on 29 and 30 November 2017.

NAS Community Services (Lancashire) is registered to provide personal care and support to people on the autistic spectrum who are living in their own homes. This included people living in shared housing as part of a supported living arrangement. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our visit 21 people used the service.

The service was managed by 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.

At our last inspection on 14 and 17 October 2017 the overall rating of the service was ‘Requires Improvement’. There was a breach of regulations relating to staff training and development. We asked the provider to make improvements on these matters. We received an action plan from the provider indicating how and when they would meet the relevant legal requirements. We also made a recommendation on improving quality monitoring systems. At this inspection we found sufficient improvements had been made.

We found there were management and leadership arrangements in place to support the effective day to day running of the service.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service. Systems were in place to ensure staff received ongoing training/learning and supervision.

There were sufficient numbers of staff at the service. Support was provided in response to people’s agreed plan of care. The use of agency staff was being monitored and kept under review.

Risks to people’s well-being were being assessed and managed. Systems were in place to support people in maintaining a safe and clean home environment.

Processes were in place to support people with their medicines. We found some matters needed improvement; however these were put right during the inspection. Checks were carried out to identify medicine errors and make improvements.

Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff said they had received training on safeguarding and protection matters. They had also received training on positively responding to people’s behaviours.

We observed positive and respectful interactions between people using the service and staff. People made positive comments about the staff team.

Arrangements were in place to gather information on people’s backgrounds, their needs, abilities, preferences and routines before they used the service.

Each person had detailed care records, describing their individual needs, preferences and routines. This provided clear guidance for staff on how to provide support. People’s needs and choices were kept under review and changes were responded to.

Staff expressed a practical awareness of promoting people’s dignity, rights and choices. People were supported to engage in meaningful activities at their homes and in the community. Beneficial relationships with relatives and other people were supported.

Processes were in place to support people with any concerns or complaints. There was an ‘easy read’ complaints procedure for people, which provided guidance on making a complaint.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and processes at the service supported this practice.

People were encouraged to lead healthy lifestyles. They were supported with their healthcare needs and medical appointments. Changes in people’s health and well-being were monitored and responded to.

People’s individual dietary needs, likes and dislikes were known and catered for. Arrangements were in place to help make sure people were offered a balanced diet and healthy eating was encouraged.

There were systems in place to consult with people who used the service, relatives and staff, to assess and monitor the quality of their experiences and make improvements.