Support to Lead

Updated 9 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.

Inspection team

One inspector carried out the inspection.

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 we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 15 September 2021 and ended on 29 September 2021. We visited the office location on 15 September 2021.

What we did before inspection

We reviewed information we had received about the service since registration. We sought feedback from the local authority and professionals who work with 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 one person who used the service and three relatives about their experience of the care provided. We spoke with five members of staff including the provider, registered manager and care workers.

We reviewed a range of records. This included three people’s care records and multiple 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

We continued to seek clarification from the provider to validate evidence found. We looked at governance systems.

Updated 9 November 2021

About the service

Support to Lead is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger and older adults with various needs including, people with physical disabilities, mental health conditions, learning disabilities and dementia. At the time of this inspection six people were using the service. Not everyone who used the service received personal care. The Care Quality Commission (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.

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

People were protected from the risks of abuse and harm and people said they trusted staff to keep them safe. Staff had received training in safeguarding people. People's care needs were risk assessed and care plans provided staff with the information they needed to manage the identified risk. Medicines support was managed safely for individual people according to their needs.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff received training in infection prevention and control and told us personal protective equipment (PPE) was readily available to them.

Staff had the necessary skills to carry out their roles. Staff had regular training and opportunities for regular supervision.

People's needs were assessed prior to starting with the service and care plans were developed according to people’s needs. People were supported to access healthcare services if required.

People and relatives told us staff were on time for their visits and if in a rare occasion staff were delayed, they were informed via telephone.

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.

People’s views and decisions about care were incorporated when their care packages were devised. People’s cultural and religious needs were met. The service promoted people to live as independently as possible and their care planning reflected this. People's right to privacy and dignity was respected.

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. The staff received training and support to enhance their skills and understanding in relation to maximising choice, promoting person-centred care and creating the right culture.

Care plans were detailed and person-centred. People had support with a range of indoor and outdoor activities where required. End of life wishes were generally discussed with people and their relatives; however, the wishes had not been documented as part of people’s care planning. We have made a recommendation about the provider considering end of life wishes as part of as people’s care planning.

Audit systems were in place to monitor the standard of care people received. Staff, people and their relatives’ views had been sought through regular contact, surveys and quality monitoring. Staff praised the registered manager and wider management team, they felt supported in their roles. People, their relatives and staff told us they would recommend the service.

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 09/06/2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staff recruitment. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.

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.