Archived: Churchview Care Services (Minehead)

There was a manager in post at the time of the inspection. The manager was planning on applying to become the registered manager. ‘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.’

Risk of abuse to people were minimised because the provider had a recruitment process in place that kept people safe. Before commencing work all new staff were checked to make sure they were suitable to work within the service and with vulnerable adults.

We looked at staff files to ensure checks had been carried out before staff worked with people. This included completing Disclosure and Barring Service (DBS) checks and contacting previous employers about the applicant’s past performance and behaviour. A DBS check allows employers to check whether the applicant had any convictions that may prevent them working with vulnerable people. Records confirmed the checks had been completed.

People were supported by staff who had completed induction training they were able to undertake further training in health and safety issues and subjects relevant to the people who were receiving a service.

Staff gave examples of what constituted abuse and what action they would take if they thought people who used the service were being abused. They informed us they would report their concerns and they were confident it would be dealt with appropriately. They were also aware they could report this to the local authority, safeguarding department and to the Care Quality Commission

There were systems in place to manage risks, safeguarding matters and medication and this ensured people's safety. Where people displayed behaviour that needed additional support, behaviour support plans guided staff and helped them to manage situations in a consistent and positive way which protected people's dignity and rights. Activities were put in place to support people to challenge their anxieties into positive actions and outcomes which reduced incidents for people.

Care plans contained risk assessments which outlined measures in place to enable people to take part in activities with minimum risk to themselves and others. Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected needs and individual wishes. The main care plans were held in the services office, smaller versions of the care plans were held in peoples individual homes.

Risk assessments and systems were in place for managing medicines in people’s home. This included the safe storage, handling and correct stocks of medicines and medication administration records (MARs).

Care plans provided detailed Information about people so staff knew exactly how they wished to be cared for in a personalised way. People were at the heart of the service and encouraged to maintain their independence. A wide and varied range of activities was on offer for people to participate in if they wished. Regular outings were also organised outside of their homes, and people were encouraged to pursue their own interests and hobbies. One person told us how they liked to travel independently, others told us of holidays they were planning with staff support.

During the inspection, we met and spoke with the registered manager and three members of staff. With permission, we visited and spoke with three people in their own homes.

We requested and received further information from the service and spoke with the provider following our visit.

The focus of the inspection was to answer five key questions;

Is the service safe?

Is the service caring?

Is the service effective?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We found the service was safe. This was because there was an open and inclusive culture at the service. People told us they could bring up any concerns with the registered manager and they would be acted upon.

Recruitment practices were safe and thorough. Policies and procedures were in place to ensure that unsafe practice was identified and people were protected from the risk of abuse.

Safeguarding procedures were robust and staff understood how to protect the people they supported. Staff had received safeguarding training in the past and were due for refresher training. Comments from people included "I feel safe ' there is a rota on my calendar to tell me who's coming', "I feel very safe ' no problems" and "I feel safe'.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. However, this is not applicable to this type of service.

Is the service effective?

We found the service was effective because people told us the service supported them to live their lives in the way they wanted.

Staff showed a good understanding of the care and support people needed. There was a keyworker system in place and staff knew individual people well. People were very complimentary of the staff. Comments included "they are brilliant - all of them", "I like them" and "X does a good job - really does a good job".

Is the service caring?

We found the service was caring. This was because staff listened to people's requests about how they wanted their care or support to be given and maintained people's independence as much as possible.

People, who received support from the service, told us staff looked after them and met their needs in a caring and helpful way. One person said "they are doing a good job; I am really pleased with them". Another person said "I get the help I need".

Is the service responsive?

We found the service was responsive because systems were in place for ensuring people's views were listened to. Staff told us they felt comfortable approaching the registered manager with any concerns and their opinions would be listened to.

People told us they had choices in their everyday lives and staff supported them to stay as independent as possible. Care and support was planned and delivered in a way that met their individual needs.

Is the service well-led?

We found the service was well-led by the provider, registered manager and team leader. A clear staffing structure and an on-call system was in place. This ensured a senior member of staff was always contactable for advice or guidance.

Staff told us they felt part of a team and were supported by management. Comments included "I love my job", "we work together as a team" and "I feel supported - I would just go to management I know them so well".

The service had systems in place to review and monitor the quality of the care and support being provided. These were used to make improvements to the service.

People praised the supported they received and the flexibility of the service. People told us that they were able to vary the support they needed. Some people arranged to have less support on one day so they could have more on another day.

Staff were trained to assist people with their medicines according to their assessed needs. People were encouraged and supported to be as independent as possible when managing their medicines.

The agency had systems in place to monitor and assess the quality of the service. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

One person told us about the help they received to manage their weight. They told us how their key worker helped them to choose and cook healthy food. They said the staff "knew them well" and took action whenever they became unwell or needed additional support.

Staff had a clear understanding of the vulnerability of some of the people who used the service and talked about their role in helping to keep them safe.

The service provided staff with comprehensive on-going training programme that enabled them to meet the needs of the people receiving support. Staff told us they were very well supported and could contact the team leader, manager or provider at any time if they needed to talk about any issues.

The service was well organised with all appropriate systems in place. Clear records enabled the provider to monitor the delivery of care. Staff were provided with clear guidance and management. This meant they had all the information and support they needed to support the people receiving support.