Aiding Independence

Updated 28 November 2017

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

This inspection took place on 05 and 06 October 2017 and was announced. The provider was given 48 hours’ notice because the location provided a supported living service and we wanted to make sure we were able to speak with people who use the service and the staff who support them.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law, like a death or a serious injury.

On the 05 October 2017 we went to the service’s office and looked at five care plans, three staff files, audits and other records. We spoke with the registered manager, one of the directors and the deputy manager. We visited and spoke with three people and two members of staff. On the 06 October 2017 we visited other people in their homes. We spoke with relatives. We also went to the service’s ‘drop in’ centre and met with other people who had support from the service.

During our inspection we observed how the staff spoke with and engaged people. We looked at how people were supported throughout the day with their daily routines and activities.

We last inspected the service in October 2015. At this time the service was meeting the requirements of the regulations and was rated ‘Good’ overall.

Updated 28 November 2017

The inspection took place on 5 and 6 October 2017 and was announced.

The service’s office is based on the main road of Herne Bay town centre and offers support and care to people within the geographical areas of Herne Bay, Canterbury and surrounding areas. Aiding Independence is registered to provide personal care to people who have learning disabilities. The service provided a supported living service for people in their own homes. Some people lived on their own in rented flats, others lived in shared houses. Each person had a tenancy agreement. Other people lived with their families. People were able to tell us about the care and support that they received. At the time of the inspection 63 people were receiving support from the service but only nine people were receiving the regulated activity ‘personal care’.

We last inspected this service in October 2015 and the service was rated as ‘outstanding’ in the caring and responsive domains. The provider continued to provide outstanding responsive care; they had developed this to enhance people’s well-being and self-esteem.

There was a wide age range of people using the service and their needs varied greatly. For some people the routine was that staff would go into their homes in the morning to assist, support or guide them with their personal care and breakfast to help them get ready for the day. The staff then returned in the evening to offer assistance and support. For others, staff were available throughout the whole day and night. Staff supported some people to participate in activities in the community while other people were able to do this independently. The service worked to give people the care and support they wanted and needed to develop their skills to reach their full potential and to be as independent as possible.

There was a registered manager working at the service. 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 registered manager, one of directors and the newly appointed deputy manager supported us

throughout the inspection.

The culture within the service was transparent, personalised and open. People were at the heart of the service. The management team engaged with people, relatives and staff consistently. People, their relatives and staff could drop in at the office at any time to discuss any issues or concerns.

The registered manager was aware that they had to inform CQC of significant events in a timely way and had done this on most occasions. At the inspection we identified two minor incidences involving people that had been reported to the local safeguarding team. The registered manager had not notified us about these two incidents when they happened but did so after the inspection. Action was taken at the time to keep people safe. The registered manager took action to make sure they informed us of significant events in the future.

Staff were clear about their roles and responsibilities and felt confident to approach senior staff if they needed advice or guidance. They told us they were listened to and their opinions counted. The registered manager had sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on whenever possible. People were able to express their opinions and views and they were encouraged and supported to have their voices heard within their local and wider community. They were enabled to promote links within the community that improved their own lives and the lives of the wider community of people with disabilities.

The quality of the service was regularly monitored. Audits and health and safety checks were regularly carried out by the registered manager and these were clearly recorded and action was taken when shortfalls were identified. The registered manager or deputy regularly checked how everything was. If any shortfalls were identified the registered manager took the appropriate action to make improvements.

The Mental Capacity Act 2005 (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. The service was fully supporting people to make decisions about all aspects of their lives and their health and wellbeing. Staff had knowledge about the MCA and how to implement it on a daily basis.

People said and behaved in a way that expressed that they felt safe with the staff who supported them. The staff understood their responsibility to recognise and report safeguarding concerns and to use the whistle blowing procedures. They had received training in how to keep people safe. There was a relaxed and calm atmosphere and people were treated with kindness, respect and compassion. The complaints procedure was available and accessible. People knew how to complain and felt confident their complaints would be listened to and acted on.

Some people were able to take their medicines independently and required no support or intervention from staff. Other people did need support, prompting and supervision to take their medicines. People received their medicines as prescribed. Medicines were accurately recorded. The staff made appropriate referrals and worked jointly with health care professionals, to ensure that people received the health care support they needed. Mealtimes were organised in the way each person preferred. People were involved in making drinks, snacks and meals as they wanted and were encouraged to eat a healthy diet.

People were involved in any new decisions that needed to be made, including recruiting new staff. Potential staff were thoroughly vetted to make sure they were safe to support people. People had the time they needed to get to know potential staff before they were able to offer any support or work in the service. The registered manager made sure the staff were supervised, supported and guided to provide care and support to people. New staff received a comprehensive induction, which included shadowing more senior staff. Staff had regular training and additional specialist training to make sure that they had the right knowledge and skills to meet people's needs effectively. People were also involved and took part in the training programme. There were sufficient numbers of staff on duty to meet people’s needs. Staff had permanent regular schedules of calls so that people received care from a consistent staff team.

The service provided exceptional care and support to people enabling them to live fulfilled and meaningful lives. There was a strong emphasis on person centred care. Staff used innovative ways to involve people in their care. People were supported to plan their support and they received a service that was based on their personal needs and wishes. The service was flexible and responded positively to changes in people’s needs. Staff supported people to go out during the day and in the evening to attend various activities in the local community. People were supported to go wherever they wanted to. People were supported to make choices and to take ‘risks’ in their daily lives. Potential risks to people were identified and assessed. There was guidance in place for staff on how to care for people effectively and safely and without restricting their activities or their lifestyles.

People had positive relationships with the staff who knew them well and used their shared interests to help people live interesting lives. People and staff had strong bonds and relationships. There was mutual respect and friendship. People valued their relationships with the staff team and felt that they often went ‘the extra mile’ for them, when providing care and support. Staff were caring and treated people with dignity and respect. Staff demonstrated a real empathy towards people. Staff responded on a daily basis to people’s changing needs. People were supported to develop their independence and confidence. There was a mixture of a familiar routine and different activities offered so that people's daily life was secure and varied. The providers were committed and worked hard to provide a service that increased people's quality of lifestyle.

It is a legal requirement that a provider’s latest CQC report rating is displayed at the service where a rating is given. This is so that people, visitors and those seeking information about the service can be informed of our judgements. We found the provider had conspicuously displayed their rating in the office and on their website.