Archived: Access All Care And Training Solutions

People’s experience of using this service:

¿ People’s relatives thought the service was exceptional and the care exemplary. One relative said, “Once they're in your lives it's never too much for them.”

¿ The service went to great lengths to promote person centred values; In one example they supported a person to employ their own team of personal assistants and assisted in their supervision.

¿ Their person-centred focus led the service to ensure staff completed specific training on specialist equipment to best meet people’s needs.

¿ Staff trained in various communication systems and technology so that people were supported to live more inclusive lives.

¿ The service employed an activities coordinator with specific remit to include and support people, their families and carers with personalised activities promoting their inclusion in the wider community.

¿The service supported families compassionately in their times of need; providing a safety net to relatives when needed and supported them navigate health, social and educational institutions.

¿ Care plans were holistic and all-encompassing. They not only recorded people’s needs and preferences, They also included details on how to care for people’s child siblings so that families could be given respite.

¿ People and professionals thought the management of the service was unique and remarkable.

¿ The service management was led by two directors, a registered manager and a deputy manager. Staff saw these leaders as inspirational role models.

¿ Staff were extremely motivated and felt passionate about the service; they were able to align their personal values easily to that of the service given it’s drive for equality and inclusion.

¿ Staff knew what to do if they had safeguarding concerns.

¿ People were risk assessed to keep them safe from harm and families were involved in these.

¿ There were sufficient staff and they were recruited with people in mind.

¿ Staff managed medicines safely.

¿ Staff understood the need to control and prevent infection.

¿ The service learned lessons when things went wrong.

¿ People were assessed before the service worked with them.

¿ Staff supported people with their food and being fed.

¿ People were actively supported to access health care professionals.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿ Relatives told us they were well treated well and that the service provided was high quality.

¿ People and their relatives were involved with their care and signed their consent to treatment.

¿ People’s privacy was respected and they were treated with dignity.

¿ People’s relatives told us they knew how to make complaints

¿ The service was not working with any one at end of life but evidenced they could.

¿ The provider used audits, spot checks and surveys to drive improvement in the service.

¿ Staff had meetings where they could be involved in the service.

Rating at last inspection: This service was previously inspected in 2016 and had been rated ‘Good’ overall.

Why we inspected: This was a planned inspection that was part of our inspection schedule.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. The next inspection will be planned for a future date based on our rating.

Access All Care is a domiciliary care agency that provides personal care and support to disabled children and young people. People who receive a service include children and young people who have autism, cerebral palsy, attention deficit hyperactivity disorder and visual, hearing and speech impairment. The service also provides support to the whole family as well as the child or young person with a disability.

At the time of our inspection, the agency was providing a service to 7 children and young people who were receiving support and help with their personal care needs in their own home. A number of other children were supported to access activities in the local community. The frequency of visits ranged from two to fifteen hours per week to a full twenty four hour care package depending on the needs of the individual child or young person and their family.

During our inspection the registered manager was present. 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 feedback we received from people was excellent. Those people who used the service expressed great satisfaction and spoke very highly of the registered manager and the staff team.

The children and young people’s safety was taken very seriously. Risk assessments were extremely detailed and there were comprehensive plans in place to make sure that risks to safety and wellbeing were addressed.

The registered manager ensured that staff fully understood people’s care needs and matched staff who had the skill, experience and knowledge to meet them.

Families had positive relationships with their care workers and the management team. There was a strong emphasis on positive support and respect for families and any care provided to children and young people was planned to support and enhance the family systems already in place.

Children and young people received a service that was based not only on the wishes of their families but their needs and wishes too. Any changes in need were quickly identified and staff updated support plans to meet those changes in need. Staff worked well with a wide range of professionals to keep the health and wellbeing of children and young people paramount and were supporting some children and young people with multiple or complex needs.

The nominated individual, the registered manager and the care co-ordinator worked as a very cohesive management team who were committed to keeping the child or young person at the centre of everything they did. They used feedback from the children and young people, their families, staff and other professionals to continually review the quality of the service. There were effective quality assurance systems in place and these included systems to understand the experiences of the children, young people and families who used the service. The management team demonstrated strong values and a wealth of knowledge and skill about how to support the people who used the service. Their own personal experiences of trying to find good quality care and support for children and young people with a learning disability in the past had led them to establish a service that had the ethos and standards they would have wanted.

The staff team were young, and this was a deliberate policy to enable them to better reflect the service user group. A high percentage of the staff had siblings who had a learning disability and this experience enabled an understanding of the challenges faced by some families. The staff were supported by the management team and had a programme of training and supervision and appraisal that enabled them to provide a high quality service to children, young people and their families.

People's needs were assessed and care was delivered in line with their individual care plan. An initial home visit was carried out to develop a care plan and carry out risk assessments with people who were new to the service. People were asked for their consent, and the provider acted in accordance with their wishes, before they received any care. People with communication difficulties were supported in understanding their options through the use of pictorial guidance.

The provider had an effective system to regularly assess and monitor the quality of service that people received. The manager carried out monthly audits of the care plans to identify whether any changes were needed. Six monthly audits of each person's risk assessments were also carried out.

Staff felt well supported. There were supervision processes in place to discuss their performance. Staff received regular training to ensure that they had the skills and knowledge required to support the people using the service. People's health, safety and welfare was protected when more than one provider was involved in their care because the provider worked in co-operation with other care professionals, such as social workers.

Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Full reviews of people's care took place annually and included all of the elements of the support plans such as specific care needs, helping people gain greater independence and setting goals with people.

Relatives told us they were happy with the care. One person said, 'they have been amazing, absolutely amazing. They have not only looked after my daughter but advocated on her behalf when she needed it'. Another said, "they have been fine, I have no complaints'.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for and supported by suitably qualified, skilled and experienced staff because appropriate references and Criminal Record Bureau checks had been made before staff started working for the service.

There was an effective complaints system available and Comments and complaints people made were responded to appropriately.