FitzRoy Support at Home Norfolk

FitzRoy Support at Home Norfolk is a care at home service providing personal and nursing care to seven people with learning disabilities at the time of our inspection. 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.

The service has 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 and what we found

People continued to receive safe care and felt safe. People were protected from the risks of abuse and risks to people's health and wellbeing were assessed, managed and regularly reviewed. There were enough staff to ensure that people's needs were met safely. People received their medicines as prescribed and there were practices in place to ensure prevention and control of infection protected people.

People's needs and expected outcomes were assessed and regularly reviewed. People were supported by staff who had relevant training, skills and experience to care for them. People had access to food and drink throughout the day. Staff worked with other health and social care professionals to achieve good outcomes for people's health and wellbeing. 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.

The staff were caring, and we received positive feedback from people and their relatives. People had supportive and meaningful relationships with staff. People received a service which was caring and respectful. People’s rights to make their own choices, independence, dignity and privacy were promoted and respected.

People's care was personalised which met their needs, and their preferences were identified and implemented. People had personalised care plans that promoted independence. Staff were proactive in ensuring people were able to follow their interests and hobbies. Staff understood people's communication needs and supported them in the best way possible using a variety of tools to support this. People were able to freely complain and could be assured their complaints would be taken seriously and dealt with promptly and professionally.

Staff were motivated and enjoyed strong team work, they felt well supported by the registered manager. The registered manager and the management team led by example. People and their relatives told us the registered manager was visible, open and approachable. People, staff and relatives felt their views were felt listened to. The service was proactive and continually worked on ways to improve.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 30 September 2016).

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.

The service provides care and support to people with a learning disability living in their own homes. The numbers of people using the service can fluctuate but at the time of our inspection, there were about 44 people receiving support. Support varied from 24-hour assistance with all personal care, to a few hours each week to support people with social activities.

There was a registered manager in post as required. 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.

Risks to people's safety were assessed and guidance provided for staff about how they should manage these to promote people's safety. Staff were aware of specific individual risks and the way they needed to support people. There were enough staff to meet people's needs. Staff understood the importance of their role in contributing to protecting people from the risk of harm or abuse and of reporting any concerns they had. Recruitment practices contributed to people's safety.

There were some gaps in training where staff had not completed updates or their Care Certificate within the provider's expected timescales. The registered manager accepted that there was a need to follow this up more robustly to fully assure themselves that staff were competent and their knowledge was up to date. However, staff were supported in their roles and could raise any queries they had about people's welfare. Staff understood the importance of supporting people in a way that enabled them to make decisions and took into account their capacity to do so. Further work was needed to ensure the rights of people, who did not understand risks to their welfare and received high levels of supervision, were protected.

People were supported to have enough to eat and drink to meet their needs, where this was a part of their care package. Staff monitored people who may be at risk of not eating or drinking enough so that they could intervene or seek advice if necessary. They also supported people to make healthy choices about their diets. If people needed advice about this or other aspects of their health, staff supported them to make and attend appointments to promote their health and wellbeing.

Staff supported people in a kind and caring way, and had developed warm and compassionate relationships with people. They supported people to make choices about their care and took into account the way that people could communicate their views. Staff treated people with respect and in a way that promoted their dignity, privacy and independence.

People received care that took into account their individual preferences and needs and was focused on meeting these. Staff responded flexibly when people's needs changed. Where people or their representatives had concerns or complaints about the care they received, they could be confident the management team would take these seriously and resolve them where possible.

The service was led in a way that encouraged people using and working in it to express their views and make suggestions for improvement. People's relatives were also consulted for their views. The registered manager used the information obtained to assess and evaluate the risks to the service, what they did well and where there were opportunities for improvement. The way the service was running and the role and involvement of the management team, contributed to good teamwork and high staff morale.