Filey Care and Support LTD

About the service

Filey Care and Support LTD provide personal care and support to people living in their own home as part of a supported living scheme. The service comprised of several small houses (supported living units) where people had their own bedrooms and en-suite facilities, and access to shared communal living areas and gardens.

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. About 80 people were using the service at the time of the inspection, out of whom 11 people received personal care.

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

Right Support:

Some risks in relation to people’s care and welfare were not thoroughly assessed which could have impacted on their safety. We also identified areas for improvement around the safe management of medicines.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

Staff enabled people to access specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.

Staff supported people to make decisions following best practice in decision-making. People had a choice about their living environment which they were able to personalise.

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.

Right Care:

People received care and support from a consistent and knowledgeable staff team. However, recruitment practices were not always safe.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People’s care and support plans reflected their range of needs and this promoted their wellbeing and independence.

Right Culture:

The service evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. However, quality assurance systems were not always effective as they had not identified the issues we found.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them were involved in planning their care.

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 8 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Enforcement

We have identified breaches in relation to safe management of medicines, assessing people’s risks, staff recruitment and the management of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Filey Care and Support Ltd provide personal care and support to people living in their own home as part of a supported living scheme. The service works with people with mild to moderate learning disabilities. At the time of the inspection there were two people using the service.

This inspection was the first inspection of the service since it was registered with the Care Quality Commission (CQC) on 15 March 2016.

There was a registered manager 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.

One person and relatives we spoke with told us that they were happy with the care and support that they or their relative received. We observed positive interactions between people and staff which promoted person centred care, choice, respect and dignity. Care staff were clearly aware of the needs of the people they supported and how these were to be met.

A number of policies and procedures were available and accessible which related to keeping people safe which included safeguarding people from abuse. Care staff understood the key principles of safeguarding people and the actions they would take if people were subject to or at the risk of harm.

Risk assessments had been completed, which identified and assessed people’s individual risks and provided guidance and direction to staff on how to mitigate or reduce risk in order to keep people safe.

Robust recruitment processes had been followed in order to ensure that staff employed to work with vulnerable people were safe to do so.

Medicines were managed, recorded and administered safely. Appropriate arrangements were in place which ensured that people received their medicines safely and on time.

All staff had received training on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and staff understood what to do if they had concerns with regards to people's mental capacity. Care staff were able to demonstrate the ways in which they obtained consent from people. They understood the need to respect a person’s choice and decision where they had the capacity to do so.

Care staff confirmed that they had received a comprehensive induction followed by training in specific areas related to their role. Records confirmed that the provider had equipped staff with the skills and knowledge required to deliver good effective care. However, not all staff had been provided with moving and handling training. The provider confirmed that this would be addressed immediately after the inspection.

Care staff told us and records confirmed that they received regular support through supervision. Care staff were yet to receive an annual appraisal as none of them had fully completed a year of employment. Care staff told us that they felt well supported by the registered manager.

Each person had a current care plan in place which contained information about the person and the care and support that they required. These were reviewed every six months or sooner where required. Care plans were person centred and gave care staff pertinent information about the person and how they wished to be supported. However, there was little information available about the person’s background, life history, likes and dislikes. The registered manager and care staff that we spoke to demonstrated that they knew people really well but some important facts had not been recorded within the care plan which would give newly recruited care staff the information they needed to support people appropriately.

People knew the registered manager and the care staff that supported them. We observed people had developed caring and meaningful relationships with all staff that was based on mutual respect. People were encouraged and supported to maintain their independence where possible.

People were supported to maintain good health and had access to a variety of healthcare services where appropriate.

People were encouraged and supported to access the community and engage in activities of their choice.

Relatives knew the registered manager and confirmed that they were in regular communication with him and all care staff. Relatives felt confident and able to raise any concerns or complaints about the care and support that their relative received directly with the registered manager. Relatives also confirmed that any concerns or complaints they raised would be appropriately addressed.

The registered manager visited people they supported at the supported living scheme on a daily basis and carried out a number of checks in order to monitor the quality of service being provided in order to learn and make improvements. This included daily well-being checks of people receiving care and support and medicine management checks. However, other than the informal notes that the registered manager made, these checks had not been formally recorded.

The service regularly requested feedback from people who used the service. However, the provider was yet to implement satisfaction surveys for relatives to complete.

Care staff told us and records confirmed that the provider held regular staff meetings which enabled effective communication exchange and encouraged staff to discuss issues and areas for improvement.