We carried out an announced inspection on 15 August 2016.Mencap - Merseyside and Lancashire Support Service is registered to provide personal care to people living in their own homes. People who use the service are provided with a range of support hours each day in line with their assessed needs. People who use the service have access to out-of-hours emergency support. At the time of the inspection Mencap - Merseyside and Lancashire Support Service was supporting 166 people.
A registered manager was in post. 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 provider moved offices in June 2015 and had a long history of providing services in the region prior to this.
The people that we spoke with had no concerns about the safety of services. The provider had delivered training for staff and managers regarding adult safeguarding. The staff that we spoke with were able to explain the different types of abuse and what action they would take if they were concerned that abuse or neglect were taking place.
The care files that we saw showed clear evidence that risk had been assessed and reviewed regularly. Risk was reviewed by staff with the involvement of the person or their relative and maintained a focus on positive risk taking to support independence.
Staff were trained in the administration of medicines but because people’s needs varied, they were not always responsible for storage and record-keeping. Some people who used the service were able to self-administer their medication, others required prompting. Medication Administration Record (MAR) sheets were completed by staff where appropriate. The records that we saw had been completed and showed no errors or omissions.
Staff were trained in a range of subjects which were relevant to the needs of the people using the service. Subjects included; safeguarding adults, moving and handling, administration of medication, Mental Capacity Act 2005 and equality and diversity. We looked at records relating to training and saw that all training had been refreshed in accordance with the provider’s schedule.
People were supported to shop for food and prepare meals in accordance with their support plans.
People’s day to day health needs were met by the services in collaboration with families and healthcare professionals. Staff supported people at healthcare appointments and used information to update support plans.
Everybody that we spoke with was positive about the way in which staff provided support, the way that staff spoke to them and the impact the service had on their life. We had the opportunity to observe staff providing support during the inspection. We saw that staff demonstrated care, kindness and warmth in their interactions with people. It was clear from their conversations and manner that the staff knew each person well and genuinely valued them as individuals.
The records that we saw demonstrated that staff and the provider paid great attention to detail in the production and distribution of information. People told us that they always felt involved in discussions and were kept well-informed about things that were personal to them. They were also given information about things happening in their region and nationally. Some people were supported to attend important events about disability rights and shared this information with other people using the service.
The staff that we spoke with described the services as promoting choice, independence and control for the individual. We were provided with a number of examples where staff and managers had engaged with people in a meaningful and appropriate way to establish goals and objectives. In each of the examples people had been supported to achieve their goals and to enhance their lifestyles, relationships, health and wellbeing.
We saw from care records and person-centred plans (PCP’s) that people were given choice over each aspect of their service. This choice included; staff, activities and times of support.
The provider encouraged people and their families to provide feedback through a range of formal and informal mechanisms. They issued annual surveys and sought feedback at each review. Information from surveys was shared with people and their families. The information was available in a range of formats on request. We saw evidence that people’s views had been used to develop the service.
The organisation had a clear set of visions and values which were communicated in brochures and other promotional materials. These visions and values were linked to organisational strategy and used as one of the criteria on which quality was assessed. Staff were able to explain the visions and values of the services and applied them in their practice.
The registered manager had robust systems and resources available to them to monitor quality and drive improvement. The provider had an extensive set of policies and procedures to guide staff conduct and help measure performance.