Background to this inspection
Updated
12 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
This inspection took place on 3 and 4 January 2019 and was announced. We gave the service one week’s notice because the location provides a supported living service for younger adults who are often out during the day. We needed to be sure that they would be in. We also wanted to be sure a member of the management team would be present during the inspection.
The inspection was carried out by one adult social care inspector.
Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also looked at information we had received about the service since the last inspection, including any notifications. A notification is information about important events, which the service is required to send us by law.
During the inspection we spoke with the regional head of operations, the deputy manager, four support workers, five people who used the service, three relatives, the volunteer co-ordinator, one volunteer, and one health professional who was visiting a person who used the service. This helped us to gather information about the service.
We looked at records relating to the management of the service including two employment records, training records, three support plans, medicine administration records, staff rotas and quality assurance records.
Updated
12 February 2019
This inspection took place on 3 and 4 January 2019 and was announced.
SeeAbility Exeter provides supported living and personal support and care to people in their own homes. Most of the people SeeAbility supports live in self-contained flats that are part of the same complex. They support people with a variety of needs including visual impairment, autism and brain injury. SeeAbility also provides an outreach service to people who live in their own homes in Exeter. SeeAbility maintains office space and a communal area within the complex.
We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, discharge if needed, people’s independence and links with their community.
Rating at last inspection
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.
At the time of this inspection there was no registered manager in post. A new manager had been appointed and they were due to begin in post a few days after our inspection. In the interim period between the previous manager leaving and the new manager starting, the regional head of operations and the deputy manager had jointly managed the service. 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. People who used the service, staff and relatives praised the Regional Head of Operations and the deputy manager for the way they had managed the service during this period.
Why the service is rated Good
The staff were passionate about supporting people to lead an independent and fulfilling life. They were exceptionally skilled and resourceful in helping people overcome problems and barriers in their lives. The organisation employed specialist staff who worked closely with each person and their staff team to find solutions to problems, and to help people achieve their goals and dreams. A person told us “My life has changed in lots of ways since I moved here.” Another person told us how their life had changed since they moved to SeeAbility saying, “Life is much more settled now. A vast improvement”. They also told us, “I am in a good environment that enables me to live my life as I want to live it”.
The staff team were highly sensitive, understanding and knowledgeable about each person’s individual support needs. They knew each person very well and understood the things that mattered to them. They helped people achieve their goals, and gain greater independence and fulfilment. A relative told us how the service had supported a person in many ways to help them gain confidence, independence, better health and quality of life. They said, “I don’t know what it would be like without them (staff).”
People were fully involved and consulted in drawing up and reviewing their support plans. Support plans and other relevant documents had been drawn up in a format each person could understand. People were encouraged to have control over all aspects of their daily lives and to have a say in their staff team and how the staff supported them. They led active lives, did the things they wanted to do, and went to the places they wanted to go.
People told us they felt safe. There were good safeguarding procedures in place. Staff and people who used the service were confident they could raise concerns and these would be listened to and addressed. Systems were in place to protect people from the risk of financial abuse.
Risks to people’s health and safety had been carefully assessed and staff knew the procedures they must follow to support people safely. Staff had received training and equipment to ensure they followed safe infection control procedures. The safety and security of people in their own homes has been given high priority. This had included the use of technology such as an electronic door entry system, vibrating door bells and fire alarms, and specialist kitchen equipment such as talking microwaves, liquid level indicators, and one cup water boilers.
Safe recruitment procedures were followed before new staff are appointed. New staff had received induction training at the start of their employment to ensure they provided safe care to people. There were sufficient staff employed and people were confident they would receive the support they needed, and at times they had requested. People knew who would be supporting them each week. The provider had acted promptly to address issues relating to staff morale and a slightly higher than expected staff turnover in the last year through a range of measures such as improving the support to staff, and closer links with senior managers. Comments from staff included, “Senior leaders are very approachable. They have visited the service and staff know them and know how to contact them” and “We have a really strong team here now. Everyone communicates well. It’s a lot more positive. Staff are much more open if there’s a problem.”
Medicines were administered safely by staff who had received training and were competent in this task. Records of medicines administered were regularly checked to minimise the risk of errors being missed.
People were supported by staff who were kind, caring and passionate about giving people the best possible care. Staff knew each person well, and understood and respected their preferences and the way they wanted to lead their lives. Staff received good training, and were supported and supervised to ensure they carried out their roles effectively. Staff were flexible and always willing to change the hours they work to suit the people they support.
People were supported to plan menus, purchase food, and cook their own meals. Staff encouraged and supported people to eat healthy meals and to maintain a healthy weight.
Staff understood people’s right to make choices and decisions about their lives, even if the choices were unwise or risky. Staff worked closely with families, health and social care professionals to make sure people’s rights were upheld. Where people were unable to make decisions about important issues, the staff followed procedures to make sure the person’s best interests were upheld. Staff upheld people’s human rights and treated each person as a respected individual.
People knew how to make a complaint and were confident any complaint would be listened to, investigated and action taken where necessary to address the issues and prevent it happening again.
People who used the service, staff and relatives told us the service was well-led. People praised the management team for making improvements to the service and for their caring and positive leadership. The staff team were positive, enthusiastic, and clearly enjoyed their jobs. The provider had systems in place to check the quality of the service they provided, and to make improvements where needed. People who used the service, staff, families and other stakeholders had been consulted and involved in the service. A member of staff told us “The organisation is absolutely brilliant!”
Further information is in the detailed findings below