Archived: Leaf Complex Care Exeter

Updated 11 August 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team:

Our inspection was conducted by one inspector.

Service and service type:

Leaf Complex Care Exeter is a domiciliary care service, registered to provide personal care to people living in their own homes in the community.

The service had a manager registered with the Care Quality Commission (CQC). This means 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 notice of the inspection visit. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection. Our inspector visited the office on 1 July 2021 to meet the management team and to review care records and other documentation. On 7 July 2021, we visited one person receiving support having asked for their consent and supported by the registered manager and a staff member.

What we did:

In planning our inspection, we reviewed information we had received about the service. This included any notifications (events which happened in the service that the provider is required to tell us about). We used all of this information to plan our inspection.

During our inspection we met with one person to ask about their experience of the care provided. We also received feedback from two family members, the registered manager, the new nominated individual, the new head of quality and compliance and one care worker. We reviewed a range of written records including two people's care plans, three staff recruitment files and information relating to staff training and the auditing and monitoring of service provision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from a further two care workers via email.

Updated 11 August 2021

About the service:

Leaf Complex Care Exeter is a domiciliary care service. It is registered to provide personal care to

people living in their own homes in the community. The service specialises in providing bespoke, long term complex care packages to support younger people with needs such as learning disability and autism. The service operates wherever people need support in Devon. At the time of our inspection, three people were receiving a 24 hour personal care service.

People's experience of using this service:

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 the 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

Staff understood people's individual care needs and preferences and used this knowledge to provide them with flexible, responsive support. This enabled people to live the life they chose. The provider took care to involve people and their relatives in planning and reviewing their care and to deploy staffing resources in accordance with their individual preferences.

Staff worked together in a mutually supportive way and communicated effectively, internally with each other and externally with a range of organisations. This included working in the same office as the Learning Disability Network. Training and supervision systems were in place to provide staff with the knowledge and skills they required to meet people's needs effectively.

Staff were kind and attentive in their approach and were committed to supporting people to maintain their independence. Staff worked in a non-discriminatory way and promoted people's dignity and privacy.

Staff worked collaboratively with local health and social care services to ensure people had access to any support they required.

Systems were in place to ensure effective infection prevention and control. People's medicines were managed safely in line with their individual needs and preferences.

People were provided with food and drink of their choice which met their nutritional requirements and promoted healthy eating.

Staff were aware of people's rights under the Mental Capacity Act 2005 and supported people to have maximum choice and control of their lives, in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

People's individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm. Staff recruitment practice was safe.

The registered manager provided open, person-led leadership and was respected and admired by her team. With their personal experience of the service user group, they were clearly passionate about ensuring people lived their best lives.

There was monitoring of the quality and safety of the service. A new Head of Quality and Compliance was working with the registered manager to devise tools to streamline and simplify auditing as the service grew. As a small new service the registered manager and provider were keen to learn. They worked with local commissioners and other organisations, sharing within the wider provider services. There had not been any concerns or complaints but there were policies in place and we saw good communication between the service and peoples’ families. The provider was committed to the continuous improvement of the service in the future.

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

Why we inspected:

The service was registered with the Care Quality Commission in January 2019. This was our first inspection of the service.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received, we may inspect sooner.