This inspection took place on 2 March 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because we wanted to make sure staff would be available to answer any questions we had or provide information that we needed. At our last inspection in October 2013 the provider was meeting all of the regulations that were assessed.
The service is registered to provide personal care and support to people in their own homes and at a supported living service. People who use the service had a range of support needs related to old age, dementia, mental health, learning disability or an eating disorder. At the time of the inspection the service was providing support and personal care to 180 people in their own homes and 19 people in a supported living unit. Supported living enables people who need personal or social support to live in their own home supported by care staff instead of living in a care home or with family. The levels of support people received from the service varied, according to their assessed needs and levels of independence.
There was a manager in post who had planned to become registered manager of 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.
People were supported by staff who had received training in how to recognise possible signs of abuse and how to report any concerns. Staff were aware of their responsibilities in this area and what actions they should take.
Recruitment processes had recently been improved to ensure that people were supported by suitable staff. Staff received induction training which included shadowing colleagues prior to working on their own. Training was in place in order to develop staff skills and staff were able to ask for additional training to develop their levels of expertise in particular areas.
Staff had not received formal supervision and had not been given the opportunity to discuss their learning or receive feedback from observations of their practice, but arrangements were in place to rectify this.
Staff were aware of the risks to the people they supported, but information held on risk assessments lacked detail which meant staff were not always provided with the most accurate information to enable them to manage risks.
People were supported to live their lives in the least restrictive way possible; staff understood the
requirements of the Mental Capacity Act [MCA], and what it meant for the people they supported.
People were supported with their nutrition and health care needs.
People told us that the staff who supported them were kind and caring and treated them with dignity and respect.
People were supported by staff who were aware of their likes and dislikes and how they liked their care to be provided.
People knew how to raise concerns and complaints; where complaints had been raised they were logged and recorded but they were not always investigated or responded to. Improvements in the complaints systems had been put in place to ensure people felt confident that their voice was heard and any lessons were learnt, where appropriate.
The manager had identified a number of areas for improvement and was working closely with the provider and staff to achieve these improvements in order to improve service delivery.
The manager was described as supportive and approachable by the staff group and her leadership skills were spoken of in a positive manner.
Quality monitoring of the service had taken place in response to particular concerns but not on a regular basis. Plans were in place to address this and obtain regular feedback from service users.