Garland Support Exeter

Updated 7 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector 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.

Service and service type

Garland Support Exeter provides care and support to people living in their own homes, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements.

Notice of inspection

This inspection was announced.

We gave the service 48 hours’ notice of the inspection. This was because the service is small in relation to personal care provision and people are often out, and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service and ten members of staff, including the registered manager, management team and two directors. We reviewed a range of records. This included two people’s care records and two medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

After our visit we sought feedback from relatives, staff and health and social care professionals to obtain their views of the service provided to people. We received feedback from five relatives, ten further staff via email and one health and social care professionals. We continued to seek clarification from the provider to validate evidence found.

Updated 7 September 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Garland Support Exeter provides care and support to people living in their own homes, so that they can live as independently as possible. 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. There were currently six people receiving a service.

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

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right care, Right culture.

Right support: Model of care and setting maximises people’s choice, control and Independence;

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. One person commented, “It’s lovely here, I love the staff. I’m going to a healthy eating workshop now so I’m happy.” People’s body language while interacting with staff was relaxed and positive, which indicated they felt safe. Relatives commented, ““[Person’s name] has a dedicated team of carers and it’s about getting the balance right, they (carers) keep her safe, but they want to make sure she has choice over her life too” and “They, (staff) do a brilliant job at keeping her safe.”

People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. There were comprehensive risk assessments in place covering all aspects of the service and support provided.

Medicines were managed as necessary. Infection control measures were in place.

Care files were personalised to reflect people’s personal preferences, needs and goals. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

There were effective staff recruitment and selection processes in place.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights;

Staff relationships with people were caring and supportive. Staff provided care that was kind and compassionate and they clearly focussed on ensuring people led the best life they could. Relatives commented, “Garland staff are very kind and sensitive, they’re willing to go the extra mile. Communication is good, they always keep me informed” and “Garland staff are really good, we’re pleased with them and hope that our other [child] can use them in the future.”

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives;

People’s equality, diversity and human rights were respected. The service’s vision and values centred around the people they supported. The vision statement was shared with staff and displayed in the office and community Hub run by the provider. This stated their vision statement was, “To enable the people we support to achieve their maximum potential and lead fulfilling lives within education, employment, independent living skills and relationships.” Our inspection found that the organisation’s philosophy was embedded in Garland Support Exeter. For example, people were constantly encouraged to lead rich and meaningful lives, try new activities and skills and enjoy quality time with friends and family.

People were supported by staff who had received relevant and good quality training in evidence-based practice. This included training in the wide range of strengths and impairments people with a learning disability and or autistic people may have, mental health needs, communication tools and positive behaviour support.

The provider worked hard to instil a culture of care in which staff truly valued and promoted people’s individuality, protected their rights and enabled them to develop and flourish.

Staff felt respected, supported and valued by the provider which supported a positive and improvement-driven culture. The provider directors were very involved in the day to day running of the service, including providing care and support for people on a regular basis. This meant they understood the environment their staff were working in and were available for support, pro-actively encouraging staff and promoting their wellbeing.

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.

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

Rating at last inspection

This service was registered with us on 2 July 2019 and this is their first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.