Archived: Choice Support Bedfordshire, Buckinghamshire and Milton Keynes

Updated 20 December 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.

This inspection took place over five days, on 23,24,25,26 and 29 October 2018 and was announced. We gave the service 48 hours’ notice of the inspection, because the registered managers are often out of the office supporting staff, and we needed to be sure that they would be available. We carried out pre-arranged telephone interviews with a selection of people on the 23 and 24 October. We visited the agency office to look at records, on the 25 October; we carried out telephone interviews with staff on the 26 October and visited people living in two of the supported living services on the 29 October 2018.

The inspection was carried out by two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert on this inspection had personal experience of caring for a person with a learning disability.

Before the inspection, the provider completed a Provider Information Return [PIR]. This is a form that asks some key information about the service, what the service does well and improvements they plan to make. We looked at the PIR prior to our visit and took this into account when we made judgements in this report. We also reviewed other information that we held about the service such as notifications. These detail events which happened at the service that the provider is required to tell us about. We also contacted commissioners for any information they held on the service and this was taken into consideration when planning the inspection.

We spoke with 10 people using the service,18 staff, one supported living manager and the three-registered managers. We reviewed the support plans for nine people using the service to check they were reflective of their needs. We reviewed six staff recruitment files, and documents in relation to staff training and staff support. We also reviewed records in relation to safeguarding, complaints, accident and incidents and management audits across the service.

Updated 20 December 2018

This inspection took place on 23,24,25,26 and 29 October 2018. The provider changed their registration with the Care Quality Commission on 16 November 2017 and this was the first inspection of the service under their new registration.

Choice Support Bedfordshire, Buckinghamshire and Milton Keynes is a domiciliary care agency. It provides personal care to people with learning disabilities and autistic spectrum disorder living in supported living accommodation and outreach services.

Care services are designed to support people with their day-to-day living activities, allowing them to remain as independent as possible in their own home. Services provided include support with personal care, meal preparation and help with medication. At the time of our inspection the provider confirmed that 91 people were receiving personal care.

This service provides care and support to people living in supported living setting, so that they can live 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.

The service had three registered managers, each covering the Bedfordshire, Buckinghamshire and Milton Keynes areas. 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 felt safe. Staff received safeguarding training to enable them to recognise the signs and symptoms of abuse and how to report abuse. Individualised risk management plans promoted people’s safety. Staffing numbers were appropriate to keep people safe. Safe recruitment practices were followed to ensure staff employed were suitable to work at the service. Medicines were managed safely and in line with best practice guidelines. Infection control procedures were followed to protect people from the spread of infection risks.

People’s diverse needs were identified at assessment, and the care and support were provided in line with their assessed needs. Staff received training based on best practice guidelines and received support and supervision to further develop their skills and knowledge. People were supported to prepare meals and snacks and to follow healthy eating plans. People were supported to access health support services and attend health appointments as and when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's consent was gained before any care or support was provided.

Staff provided people’s support in a caring and supportive way. People’s choices were respected, and their privacy and dignity were maintained always. People and their relatives were fully involved in all decisions about their care and support. People were supported to raise any concerns or complaints about the service.

Effective governance systems were used to oversee, improve and drive continuous improvement across the whole of the service.