Positive Steps Care & Support Ltd

Updated 24 November 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five members of staff, which included the registered manager and provider representative.

We reviewed a range of records. We looked at four staff files in relation to recruitment and various policies and procedures were reviewed. We requested a variety of records were sent to us relating to the care and support provided, staff training and regards the management of the service. These included specific audits/reports relating to the quality and safety of the service to ensure people received safe care and support specific to their individual needs.

After the inspection

After our visit we sought feedback from people who used the service, relatives, health and social care professionals and staff to obtain their views of the service provided to people. We received information from three additional staff, four people who used the service and their relatives. Unfortunately, we did not receive any feedback from health and social care professionals. We continued to seek clarification from the provider to validate evidence found. We provided initial feedback to the service on 5 November 2021.

Updated 24 November 2021

About the service

Positive Steps Care & Support Ltd is a domiciliary care agency providing personal care to people living in their own homes in Plymouth and Cornwall. There are currently eight people receiving a service. 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. The service mainly supported people with complex needs. For example, people with a learning disability, Huntington's disease and an acquired brain injury.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

Care is person-centred and promotes people’s dignity, privacy and human rights

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 organisation’s statement of purpose documented a philosophy of maximising people’s life choices, encouraging independence and people having a sense of worth and value. Our inspection found that the organisation’s philosophy was embedded in Positive Steps. For example, people were constantly encouraged to lead rich and meaningful lives.

The service provided safe care to people. One person commented, “I have no complaints; I feel at ease with my carers.” Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. 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.

Staff relationships with people were caring and supportive. Staff provided care that was kind and compassionate. One comment received about the service stated, “Excellence in care. Absolutely brilliant, excellent. They (staff) are a flagship of care.”

There were sufficient staff to meet people’s needs. People were supported by a core team of staff. Relatives valued the consistency of staff to ensure structure and familiarity. Staff confirmed people’s needs were met and felt there were sufficient staffing numbers. The registered manager explained staffing arrangements always matched the support commissioned and staff skills were integral to this to suit people’s needs. They added that people received support from a consistent staff team. This ensured people were able to build up trusting relationships with staff who knew their needs.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development.

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 18 February 2020 and this is their first inspection.

Why we inspected

This was a planned inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Positive Steps Care & Support Ltd on our website at www.cqc.org.uk.

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.