4EDEN

Eden Mencap Society is a domiciliary care agency. The service provides care and support to people living in five ‘supported living’ settings, so that they can live in their own home as independently as possible. Two people were also given support who were living in their own homes in the community. People’s care and housing were provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had 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.

People’s experience of using this service

Since the last inspection the service had made improvements in a number of areas. These included: strengthening systems to protect people from harm and abuse; ensuring staff had a good working knowledge of the Mental Capacity Act 2005; and making sure checks on how service runs were more robust.

People were very happy with the support from Eden Mencap Society. They told us staff helped them to lead interesting lives of their choosing.

People felt safe and were protected from the risk of harm. People were supported to manage their medicines safely. Staff completed medication training and had their competency checked. There were sufficient numbers of staff who were safely recruited. Staff supported people to be independent whilst also managing risks. 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.

Care plans were person-centred and contained information about people’s life history and their preferences. Staff were knowledgeable of people’s care needs and the actions needed to reduce risks to people. They received training, supervision and appraisal to equip them for their role. People were supported by staff to access healthcare services. Staff provided good examples of occasions when they recognised a deterioration in people’s health and had taken action.

Everyone told us staff were kind, caring and considerate and staff went to great lengths to help them live their lives to the full. They were supported by staff who met their equality, diversity and human rights. People’s communication needs were recorded in care plans and they had numerous ways to engage in the running of the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensured people who used the service lived as full a life as possible and achieved the best possible outcomes that included control, choice and independence. 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 be active citizens and to fully engage in the local community. This included part-time and full-time work.

The management of the service had been strengthened by the recruitment of a second registered manager to the senior team. The senior team had developed more robust systems for checking the quality and safety of the service and they had strengthened links with the organisation’s trustees.

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 requires improvement (published 17 September 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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 service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The service also provides care and support to people living in four ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Eden Mencap Society receives personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection there were 6 people receiving support with their personal care.

The service operates from permanent offices close to Penrith town centre.

There was a registered manager at the service. 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.’

The care service was not fully developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

The human and legal rights of people who used this service were not protected because staff, including the management team, did not have a good working knowledge of the principles of the Mental Capacity Act 2005.

The service did not have effective safeguarding systems in place.

People's finances and medicines had not always been managed safely. Where mistakes had been identified, appropriate actions had not been taken to help make sure they did not happen again.

The service did not have a robust and effective system in place to monitor the quality and safety of the service.

These are breaches of the regulations.

You can see what action we told the provider to take at the back of the full version of the report.

Risk assessments and care records had not been maintained accurately and did not reflect people’s current support needs. The documents were not produced in a way that met the communication needs of the people using the service.

We have made a recommendation about communication and accessible information.

The provider had a complaints process. No one that we spoke with had ever needed to raise a complaint. However, we did see some evidence of complaints during our visit to the office. The complaints system was not well managed.

We have made a recommendation about the management of complaints.

The service operated a safe recruitment process to help make sure only suitable people were employed. There were usually enough staff on duty to meet people’s needs. We found that people usually had support from the same team of carers who knew them well.

Staff were provided with some training and updates. They told us that they felt well supported by the management at the service. However, we noted that there were gaps in their skills and knowledge, particularly around keeping people safe.

Staff at the service knew the people they supported very well. They could give a good account of people’s individual care and support needs.

People we spoke with during the inspection process were all happy with the support provided by the service. They all thought that people were “well looked after.”

People were supported to access health and social care professionals when needed, as well as independent advocacy services. Additionally, people were supported to access activities and employment in the local community or to attend day centres and clubs.

Eden Mencap Society is a registered charity supporting children and adults, who have learning disabilities in the Eden Valley of Cumbria. The agency provides services that are based in a person's home and a supported living service. The service has an office base in Penrith. The supported living service is provided to people in order to promote their independence.

The service runs horticultural and catering schemes for people attending the centre. There is also a community based café and this placement builds on skills and prepares those receiving services for employment.

There was a registered manager in post at the time of 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 and their relatives told us this was a good service that provided safe support to those who used Eden Mencap.

We found that the service was safe and members of the staff team were aware of their role and responsibility to keep people safe. There were sufficient staff to provide the appropriate level of care and support.

Staff had completed training in the protection of vulnerable people. They knew part of their role and responsibility was to keep people safe from the risk of harm or abuse.

We saw that the provider had appropriate recruitment policies and procedures in place which ensured only suitable people were employed to care for vulnerable people, some having complex needs.

Risk assessments covering all aspects of care and support were in place and reviewed every month or more often if people’s needs changed.

We found that staff training was up to date. Following their induction some staff then completed other specific training according to the needs of the people they supported.

We saw that medicines were handled correctly and in line with peoples’ prescriptions.

People were included in all decisions about their care and their rights were respected. The service followed the requirements of the Mental Capacity Act 2005 Code of Practice. This helped to protect the rights of people who were not able to make important decisions for themselves.

Staff received regular supervision and appraisal that ensured good work practices were maintained.

Staff had formed close relationships with the people they supported. Privacy and dignity were respected at all times. People were encouraged to access activities in the community which helped them to retain their independence.

There was an appropriate internal quality monitoring procedure in place to monitor service provision. Checks or audits were completed in respect of medicines administration, care plans, personal involvement, health and safety and risk assessments. These checks ensured people were cared for and supported in the way people preferred.