Taylor Made Care Ltd

Updated 18 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 48 hours’ notice of the inspection visit because this is a small domiciliary care and supported living service; and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 28 February 2018 and ended on 21 March 2018. It included sampling people’s care records talking with people and a relative about the care provided and finding out the views of other health and social care professionals about the quality of the service. We visited the office location on 28 February 2018 to see the manager; and to review care records and policies and procedures. We spoke with people, a relative and staff up to 21 March 2018, to find out what they thought about the care provided.

The inspection was carried out by one inspector.

We requested information about the service from a social care professional, who was happy to share the information they supplied and for us to consider this within our inspection. We requested information about the service from the local authority and Healthwatch. The local authority has responsibility for funding some people’s care and monitoring their safety and quality. Healthwatch is the local consumer champion for health and social care services.

We considered the information the provider sent to us in the Provider Information Return [PIR]. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan this inspection.

We spoke with all three people who use the service, a relative by telephone following our visit to the office by telephone. This was to establish people's views about the care and support provided. In addition, we spoke with all four staff currently employed by the provider about their supporting roles.

Whilst at the office we talked with the provider who is also the registered manager. We looked at a range of documents and written records. These included sampling four people's care plans and daily records, three staff recruitment files and key policies and procedures, such as how people’s rights were promoted and how staff would respond to any complaints made.

We also looked at information about how the registered manager monitored the quality of the service provided. This included the actions the registered manager took to develop the service further, such as on-going staff training, organisation of staff rota’s and quality checks, to assure themselves people received a caring quality service which was safe, effective, responsive and well led.

Updated 18 April 2018

Taylor Made provides care and support to people living in one ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

We undertook an announced inspection on 28 February 2018.

This is the first inspection of Taylor Made following their registration and at the time of this inspection everyone using Taylor Made receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, that is, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, three people were being supported with personal care in a shared house.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

There was a registered manager in post who is also the registered provider. 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.

People were supported to make safe choices in relation to taking risks in their day to day lives. Staff had been trained and understood how to support people in a way which protected them from danger, harm and abuse. Staff had been recruited following appropriate checks on their suitability to support people in their home and keep them safe. The registered manager had arrangements in place to make sure staffing resources were flexible to meet people’s individual needs and provided people with support in their home and when going out.

People were provided with the right support for them when taking their medicines by staff who had been provided with the training to do this safely. Regular cleaning and hand hygiene practices adopted by staff made sure infection control was maintained to prevent cross infections.

People were supported by staff who had received the appropriate training and had the skills and support to carry out their roles. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This included involving people in decisions about their day to day care. Staff knew which people may need help to make some key decisions about their lives and understood what action to take so people received the support they needed in these circumstances.

People told us that they were happy with the way in which staff supported them with cooking their meals, learning about different foods to keep them healthy and in accessing health and social care services when they needed them.

People liked their home and felt they had the facilities they required to meet their individual needs. People valued the support they received from the registered manager and staff in supporting them if they required additional aids in their home to effectively meet their needs.

People who used the service, a relative and a social care professional described the care people received as meeting people’s needs in a positive way. Staff and the registered manager were caring and showed a genuine warmth and commitment to people they supported. People felt they mattered to staff and were involved in every aspect of their lives. Where communication and people being supported to lead independent lives could have been a barrier for people the registered manager led by example to find ways to ensure people could lead fulfilled lives and communicate in a way that suited them. Staff took action to support people so their rights to dignity, independence and privacy were maintained.

People’s needs were assessed and staff understood these and responded appropriately when people’s needs changed. People’s interests and preferences were documented and they were encouraged to pursue social events and areas of interests. Social inclusion was an important priority for people and both the registered manger and staff who supported them.

Staff were happy in their work and were clear about their roles and responsibilities. There was an ethos of keeping people at the heart of their care amongst the staff team which was fully promoted by the registered manager. This ethos supported staff in a variety of ways to be the best they could be.

People were encouraged to share their opinions about the quality of the service through regular conversations with the registered manager and staff.

The registered manager had a clear vision for the service that was shared by their staff team. This vision was about complete inclusion and involvement of people in shaping their lives and the service. This vision was embedded within staff practices and evidenced through the conversations we had with people who used the service.

Leadership of the service at all levels was open and transparent and supported a positive culture committed to supporting and enabling people with learning disabilities.