Stockdales Domiciliary Support Services

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Safeguarding systems were in place and staff had received training. Staff recruitment systems were robust and staffing levels were sufficient to meet the needs of the people using the service.

General and individual risk assessments were kept and the service had appropriate health and safety measures in place. Accidents and incidents were recorded appropriately. Medicines were given safely and staff had received appropriate training.

We saw evidence thorough assessments of people’s needs were carried out. Care plans included relevant health and personal information.

The staff induction was thorough and training was on-going. Staff had regular supervisions and annual appraisals. The service was working within the legal requirements of The Mental Capacity Act 2005 (MCA).

Staff were given training in dignity in care and equality and diversity. All staff understood the importance of confidentiality and data protection.

All the relatives we spoke with felt dignity and privacy were respected by staff. People told us they had been involved in the care planning and review processes. People who used the service were supported to be as independent as possible.

Care plans were person-centred and the service looked at matching staff with people who used the service to help ensure compatibility and consistency. There was an activities timetable for each person and these were individual and tailored to the person involved.

The service ensured they worked in line with the Accessible Information Standard. Staff had received training in end of life care.

There was a complaints policy and complaints and concerns had been logged and responded to appropriately. The service had received a number of compliments.

Staff felt they were well supported by the management. There were regular staff meetings. The service was involved with the wider community with activities and groups attended. They worked in partnership with other agencies to help provide a joined-up service.

A number of audits and quality assurance checks took place and feedback was sought from people who used the service to help inform service improvement.

Further information is in the detailed findings below

The previous inspection had been conducted on 12 December 2013. At this inspection, we found that the service had met all regulatory requirements.

Stockdales of Sale, Altrincham and District Ltd is a registered charity that provides care and support to children and adults with learning and physical disabilities. Stockdales Domiciliary Support Services (Stockdales) is the company’s community and home support service, registered to provide personal care and support to people with a learning disability and other complex needs within a community setting. Stockdales aim to provide person centred support services which help people remain in their own homes and enable people to lead as independent a life as possible within their own community. The type of support offered includes help with care at home, accessing community services, respite care in a person’s home, help to access medical care, weekend breaks, and supporting people to socialise with others and build friendships. Stockdales also provides, through its Lifeskills programme, a broad range of practical, social and educational activities designed to help people with learning disabilities maintain their independence, build their self-confidence, make friends, and participate in activities they may not usually get the opportunity to do. At the time of our inspection, Stockdales supported eight people in the community who also accessed the Lifeskills programme.

The service had a manager who had been registered with the Care Quality Commission (CQC) since February 2012. 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 and relatives told us they felt safe with the care and support they received. Relatives told us they felt reassured that staff providing support and care was consistent. All staff had been trained in safeguarding principles and knew what to do if they saw abuse occurring. People were protected from unsafe care and treatment because there were effective systems in place to review and monitor people’s safety.

There were risk assessments in place for people using the service. These provided clear direction to support staff to manage risk appropriately to meet people’s specific needs.

Stockdales had safe recruitment processes in place to ensure that staff were fit for the job they were recruited to do.

Health and safety records reviewed showed that the service had done equipment checks in line with manufacturers’ instructions and best practice. The area used for Lifeskills sessions, which included a changing area and toilet, were clean and well-kept.

Stockdales had a robust policy and procedure in place for staff to follow when administering medication to those people who needed assistance. The competence of staff administering medication had to be validated before they were able to do so.

People using the service and their relatives told us they felt that staff were competent. There was a good induction process in place and all new starters had to complete mandatory training such as health and safety, safeguarding awareness, infection control, and moving and handling. Staff were well supported in their roles and received additional role-specific training. Staff were also supported with regular professional development in form of regular one-to-one supervision meetings and an annual appraisal of their performance with their line manager.

We were told that the service recruited volunteers using the same process and during our inspection we saw a volunteer being interviewed.

Staffing levels were determined based on people’s needs and dependency levels. Relatives told us they were confident that there were enough staff to support people’s needs.

The service worked within the principles of the Mental Capacity Act 2005 (MCA). MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty in order to receive care and treatment when this is in their best interests and legally authorised under the MCA. In the case of domiciliary care services, applications must be made to the Court of Protection. The service had not needed to make any applications to the Court of Protection.

People using the service and their relatives found that both staff and management at Stockdales were kind and caring and we saw that people had developed good relationships with their support workers. We observed that support workers treated people with kindness and respect and that there was good interaction between people and support workers. The service promoted people’s independence and helped them develop friendships and enjoy the social interaction with other people at the service. Staff and management knew the individuals they supported and demonstrated this by telling us about people and their preferences.

People who used the service felt they were involved in making decisions about what affected them and that their views and opinions were listened to and acted upon. The service facilitated a consultation group made up of people using the service and relatives which acted like an advocacy group; they helped to identify areas of good practice and those needing improvement.

Stockdales promoted diversity and creativity by taking part in one of Manchester’s annual summer parades. The people using the service were central to the design and making of fancy dress costumes for the parade.

The service was consistently responsive and used person centred planning to tailor its service provision to meet the person’s specific needs. People and their relatives told us that they had been involved in the care planning process. People were encouraged and supported to get involved in a wide variety of activities and trips allowing them to step out of their comfort zone and engage in different types of activities. The service recently piloted a project called “Dream Days” which was about making people’s dreams and aspirations a reality.

We saw that complaints were well managed and that people were encouraged to raise concerns and complaints formally or informally. The service had received few formal complaints.

People and relatives had confidence in the management and staff of Stockdales. The registered manager and their management team were well known and everyone we spoke with including staff said that they were very approachable and proactive.

The registered manager had a clear vision for the future growth of the service. The service also developed a mission statement and a set of values which were discussed with staff during their induction and reinforced in supervisions.

The provider undertook an annual satisfaction survey and we saw that people and relatives responded positively. There were appropriate forums for both people using the service and staff to discuss ideas for improving the service and feeding this back to management.

There was a robust system of audit and quality assurance mechanisms in place to monitor service quality and delivery and thus gave the registered manager and the provider good oversight of all operations.

Stockdales worked closely with other organisations and groups within the local and wider community and had initiated a partnership with the local leisure centre to enable people with more complex care needs greater access to community facilities.

The provider participated in quality improvement schemes such as “Driving Up Quality” code and the Investors in People (IIP) accreditation. Driving Up Quality code is a voluntary code of conduct geared towards improving the quality of services for people with learning disabilities. IIP provides a best practice people management standard, offering accreditation to organisations that adhere to the IIP framework. During our inspection, they were in the process of having their IIP accreditation reviewed.

We found support plans and risk assessments were in place which provided clear instruction to staff to meet the individual needs of the person who used the service.

We found there was a comprehensive medicines policy in place which included guidance on administration and medication errors.

We looked at a training matrix that provided details of training received and when refresher training was required and included safeguarding adults and children, food hygiene, infection control and manual handling.

We found the provider had systems in place to monitor the quality of the service they provided. This included regular reviews of support plans and risk assessments in response to changing needs of people who used the service.

All records we looked at were paper based, they were accurate and maintained to a good standard.