Better Lives (Northants) LTD

About the service

Better Lives (Northants) LTD provides care and support for people with a learning disability or autistic people. The service provides care and support to people living in their own homes and to people living in a 'supported living' setting; the people receiving support at the time of inspection lived in their own homes in the community and a four bedroom ‘supported living’ house. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, the service was supporting 8 people with personal care.

People’s experience of using this service and what we found

The service demonstrated how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support:

Staff were aware of and followed best practice and the principles of Right Support. People received person centred support and their needs were met. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful life. Staff supported people to play an active role in maintaining their own health and wellbeing. People were supported with their medicines in a way that promoted their independence. People were enabled to access all the health and social care services they needed. The ‘supported living’ service people received was provided in accommodation, which was similar to the other houses in the area. People were supported to keep their home clean and well maintained. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs and promoted equality and diversity in their support for people. The service had enough appropriately skilled staff to meet people's needs and keep them safe. Staff understood people’s communication needs and supported their communication appropriately. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. Staff and people worked together to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

People received good quality care and support because trained staff could meet their needs and wishes. People were empowered because of the ethos, values, attitudes and behaviours of the management and staff. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people's wishes, needs and rights at the heart of everything they did. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people's views.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 25 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using the service received the regulated activity related to domiciliary care; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, six people were receiving personal care support.

At the last inspection in March 2016, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

We found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

There was a registered manager at the time of our inspection. A registered manager is a person who has registered with the CQC 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 cared for safely in their own home and when supported to access the community with staff. There were sufficient numbers of staff to support people safely; recruitment practises ensure that staff were suitable to work with people with learning disabilities. Risk management plans were in place to protect and promote people’s safety.

People had personalised care plans that reflected their individual needs and aspirations. Staff had the information and guidance they needed to provide people with the care and support they needed. People's privacy and dignity was respected at all times; they had positive relationships with staff and received care in line with best practice. Staff consistently provided people with respectful and compassionate care.

The provider understood and acted upon their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016. The AIS is a framework that makes it a legal requirement for all providers to ensure people with a disability or sensory loss can access and understand information they were given.

People were encouraged to be involved in decisions about their care and support. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care.

People were supported to have sufficient amounts to eat and drink and to maintain a balanced diet whenever this was part of their agreed care plan.

The service had a positive ethos and an open culture. The registered manager was a visible role model in the service. The provider continually monitored the quality of the service provided.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received. Information was available in various formats to meet the communication needs of the individuals. Arrangements were in place for the service to reflect and learn from complaints and incidents to improve the quality of care across the service.

There were two registered managers in post. 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 managers owned the business and as a provider they had clear vision and values that were person centred and focussed on people having the opportunity to gain their independence. All staff and managers demonstrated passion and commitment to providing a good service for people.

People had therapeutic relationships with staff. People commented on the positive impact staff had made on their lives and how they had changed for the better. People understood they could rely on staff to always be there for them and to provide guidance when needed during difficult times.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People were empowered to make their own decisions and to take responsibility for them. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.

People’s lives had improved as a result of using the service; people were enabled to become more independent by gaining everyday life skills and understanding how to care for their health and well-being.

People received safe care and support. Staff understood their role in safeguarding people and they knew how to report concerns. There were enough staff with the right skills and attitudes to meet people’s needs. The provider included people in the in-depth recruitment and selection of new staff.

Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.

There was a person centred and flexible approach to each person’s nutritional needs and staff promoted healthy eating. Individuals were supported to realise the knowledge and understanding they needed to attain a healthy weight, plan and prepare meals and keep their food safely stored.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals

Staff protected people’s privacy and dignity. All interactions between staff and people were caring and respectful; staff were consistently patient, kind and compassionate. Staff demonstrated affection and warmth in their contact with people, which was clearly reciprocated.

Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people were confident that if they had any concerns they would be listened to and any concerns would be addressed.

Systems were in place to monitor the quality and safety of the support people received. People and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement.

We found the agency to be appropriately managed and we saw that people received reliable, safe and effective support that enabled them to develop their confidence and participate in community activities.