Allerton C&S NE Limited

Allerton C&S NE Limited (previously Navigation Support & Care Services) is a domiciliary care service that provides personal care and support for people in their own homes who have a learning disability or autism. The service can provide care for adults of all ages and covered Lincoln and surrounding areas.

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 our inspection the service was providing support for 18 people.

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

People and staff provided positive feedback on the management of the service. Relatives raised some concerns regarding communication; the provider was taking action to address this.

There were systems and processes in placer to identify and manage risks to people’s care. There were organisational governance processes in place to monitor the quality of the service.

People were supported by sufficient numbers of staff who had been recruited safely. However, the provider did not have an on-going system in place to follow up on the check of criminal records.

People received their medicines from staff who had been trained to safely administer medicines.

Staff had received training on infection prevention and control. Information and guidance on infection control measures were available for staff and people. However, the provider did not have a robust system in place to monitor weekly COVID-19 testing.

People and their relatives told us they felt safe with the staff who supported them. Staff had received safeguarding training and were able to demonstrate their understanding and responsibilities to reduce the risk of harm to people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. The service demonstrated person centred care, with open and transparent leadership promoting a positive culture.

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

Rating at last inspection

The last rating for this service was good (published 10 May 2019).

Why we inspected

We received concerns in relation to the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allerton C&S NE Limited on our website at www.cqc.org.uk.

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.

Navigation Support and Care Services is a domiciliary care service that provides personal care and support for people in their own homes who have a learning disability or autistic spectrum disorder. The service can provide care for adults of all ages. At the time of our inspection the service was providing support for 54 people. The service covered Lincoln and surrounding areas.

People’s experience of using this service:

People were very satisfied with all aspects of the service provided and spoke highly of staff and the registered managers. People who used the service told us they were treated with compassion and kindness and that their privacy and dignity were respected.

People who used the service and relatives we spoke with told us they felt staff provided safe and effective care. Staff turnover was low which people and relatives valued. People were supported by a small team of staff that understood their needs.

We found that there were systems, processes and practices were mostly followed to safeguard people from situations in which they may experience abuse including physical harm. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected.

People told us they received their medicines as prescribed. Medicines Administration Records (MARs) reviewed had been completed by staff and were regularly audited by management.

Background checks had been completed before new care staff had been appointed. People were protected by there being arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Staff had received all the training required to support people safely. Staff received regular supervision and annual appraisals and were able to reflect on the care and support they delivered. Staff were able to identify further training in addition to their mandatory training.

People had their rights protected under the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their nutritional needs when required. People had been supported to live healthier lives by being supported to have suitable access to healthcare services so that they received on-going healthcare support. Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People received personalised care that was responsive to their needs. Care staff recognised the importance of promoting equality and diversity by supporting people to make choices about their lives. Confidential information was kept private.

There was strong sense of leadership in the service that was open and inclusive. The registered persons focused on achieving positive outcomes for people and their staff. There had been occasions when the service did not always communicate effectively with health and social care professionals and their recommendations not followed.

People benefited from a robust professional management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met.

The service encouraged feedback from people who used the service, relatives and care staff. Views were gathered through questionnaires, telephone conversations, regular face to face meetings at their home or in the office.

One complaint had been received in the last 12 months and this had been responded to appropriately. People were introduced to lay advocates if necessary.

Quality checks had been completed to ensure people benefited from the service being able to quickly put problems right and to innovate so that people could consistently receive safe care.

Good team work was promoted and care staff were supported to speak out if they had any concerns about people not being treated in the right way. Staff were clear about the vision and values of the service. In addition, the registered persons worked in partnership with other agencies and stakeholders to support the development of joined-up care.

More information is available in the full report.

Rating at last inspection:

Good (report published March 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

There was 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People had been supported to safely manage medicines. Risk assessments and management plans were in place to help keep people safe. There were enough staff to provide support to people. Background checks had been completed before new staff were appointed.

Staff had received training and support to help them to support people in the right way. This included being able to assist people to eat and drink enough in order to stay well. In addition, people had been supported to receive all of the healthcare assistance they needed.

Staff were kind to people. Care was provided in order to meet the choices people had made as part of the planning process. Staff knew how to support people who became distressed. Where people were unable to verbally communicate arrangements were in place to ensure that staff were able to communicate with people on their terms.

Staff understood about consent and what to do if people refused care and support. The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This act is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

The provider used a number of methods to ensure that people had been consulted about the support they wanted to receive and they had been given all of the assistance they needed. Staff had supported people to pursue their interests and hobbies. People were offered a range of activities and support in order to access these. The provider went out of their way to respond to people’s life experiences and diversity. There was a system for resolving complaints which was provided in different formats so that it was accessible to people.

Regular quality checks had been carried out to ensure that people received the appropriate support. There was a culture of openness and staff were supported to raise concerns. The service was run in an open and relaxed way. People, staff and relatives were able to raise issues and were confident that they would be resolved.