Yourhealthcare Community Interest Company

About the service

YourHealthcare Community Interest Company offers a shared lives scheme which provides people with long term placements within shared lives carers (SLC) own homes. At the time of inspection, there were seven people receiving support with personal care from this service. In this report we refer to the shared lives carers as 'carers.'

The Care Quality Commission (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.

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support:

The service supported people to have the maximum possible choice, control and independence. Carers supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care:

Carers promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. Carers understood how to protect people from poor care and abuse. Carers had training on how to recognise and report abuse and they knew how to apply it. Carers and people cooperated to assess risks people might face. Where appropriate, carers encouraged and enabled people to take positive risks.

Right Culture:

People received good quality care, support and treatment because trained carers and specialists could meet their needs and wishes. Carer turnover was very low, which supported people to receive consistent care from staff who knew them well. The provider evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 18/10/2109) and there were breaches of regulation in relation to safe care and treatment and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had been made and the provider was not in breach of regulations.

Why we inspected

This inspection was carried out to look at improvements against the breaches found at the previous inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Home Care Service Provider on our website at www.cqc.org.uk.

Your Healthcare Community Interest Company is a shared lives scheme which provides people with long-term placements within shared lives carers (SLC) own homes. At the time of inspection, five people, some of whom have learning disabilities, were receiving support with personal care from this service. In this report we refer to the shared lives carers as 'carers.'

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

The service was not consistently well-led. Quality assurance processes were not in place to monitor the quality of the care provision, including accuracy of care records, carers’ training needs and management of people’s medicines. Risks to people's health and safety were not sufficiently identified and assessed to ensure safe care delivery for people.

Carers were not always supported in time to update their knowledge and skills in all areas required for their role. We made a recommendation about this.

People’s care plans lacked details on how people wanted to be supported. The management team told us they would address this concern immediately. We will check their progress at our next comprehensive inspection.

There were policies and procedures in place for carers to follow should they noticed people being at risk to harm or when incidents and accidents took place. Carers were required to undertake appropriate checks before they were employed by the service. People had assistance to manage their medicines safely.

People were supported to have maximum choice and control of their lives and carers supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. A comprehensive assessment was carried out to match people with carers which ensured a good placement provision. People had support to attend to their health needs when they needed to. Carers encouraged people to get involved in their meal preparations.

People felt respected and listened to by the carers that supported them. People were encouraged to make choices for themselves and have a say in the decision-making process. Carers encouraged people to maintain and further develop their independence skills where they had been able to. Personal information about people was kept safe.

People told us they would address their concerns should they have any. The service worked to update the guidance provided to people with difficulty reading to help them understand the information better. The management team told us they planned to have conversations with all people about their end of life care to ensure their wishes were adhered to as necessary.

People and their circle of support felt there was a good care provision at the service. People were encouraged to provide feedback on how they valued the service. Carers felt that the registered manager was responsive and guided them well.

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 24 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We have identified a breach in relation to people's risk management plans at this inspection. Please see the action we have told the provider to take at the end of this report.

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Your Healthcare Community Interest Company provides a shared lives scheme across the Royal Borough of Kingston. The scheme matches an adult who has care needs with an approved shared lives carer. Shared lives carers accept people into their own homes and provide care, support and mentorship to people. The shared lives carers are self-employed and have a contract to work with Your Healthcare Community Interest Company. At the time of our inspection four shared lives carers were providing support to seven people. Some people using the service had a learning disability and others were older people some of whom had cognitive impairment. In this report we refer to the shared lives carers as ‘carers’ and the shared lives scheme staff as ‘staff’.

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.

There were comprehensive systems in place to ensure only suitable carers were recruited who had the right knowledge, skills and attitudes to provide a shared lives service. Staff assessed the risks to people’s safety and provided carers with information and support about how to mitigate those risks. This included risks to people at home and in the community. Carers were provided with information about how to safeguard people from harm and there were regular discussions to ensure people were not discriminated against. Carers supported people to have their medicines and medicines management was checked by staff during their visits to people’s homes to ensure the provider’s medicines management policy and procedures were being followed.

Shared lives staff adhered to the provider’s mandatory training. The provider had scheduled training to ensure the carers had access to up to date information and good practice guidance about how to meet people’s needs. Carers were supported through regular contact and supervision visits by the shared lives staff. Staff worked with carers and people’s social workers to ensure people received support in line with the Mental Capacity Act 2005 (MCA). Staff provided carers with information about people’s health and nutritional needs so they could be supported appropriately.

People were involved in decisions about their care and how their support was provided. Staff provided carers with information about people’s communication needs so they could communicate with people appropriately and involve them in their care. People and their carers were respectful of each other’s individual differences, cultural and religious preferences. Carers respected people’s privacy. Carers involved people in their own families and supported people to maintain contact with their relatives.

Staff, together with people’s social workers, assessed people’s needs and the level of support they required. This information was provided to their carers to ensure they received support in line with their needs. Carers encouraged people to maintain their independence and use their skills. Some people were being supported to access education and employment opportunities. Systems were in place to manage any complaints that arose.

Staff checked the quality of service delivery through regular visits to the shared lives homes. They encouraged people and their carers to feedback about the service and to identify any areas for improvement. Staff checked that people received the support they required and appropriate documentation was maintained. The provider gathered key performance information about the service and this was shared with their commissioners. The staff accessed the London and South East shared lives network to share experiences and obtain peer support. The provider and registered manager were aware of their responsibilities as registered persons and adhered to the requirements of their Care Quality Commission registration.