Archived: Enfield Adult Placement Scheme

Updated 17 June 2016

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.

The inspection took place on 27 April 2016 and was announced. The provider was given 48 hours’ notice because the location provides a shared lives scheme. The inspection was carried out by one inspector.

Before the inspection we looked at information we had about the service. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During and following the inspection, we spoke with three people who use the service, two relatives, four adult placement carers, an adult placement officer and the registered manager. We received feedback from four health and social care professionals. With permission, during the inspection we visited and spoke with two people and a carer in their home.

We reviewed the records and risk assessments of three people who use the service and five staff files and records related to the management of the service.

Updated 17 June 2016

This inspection took place on 27 April 2016. This was an announced inspection and the provider was given 48 hours’ notice. This was to ensure that someone would be available at the office to provide us with the necessary information to carry out an inspection. When we last inspected this service on 24 February 2014 we found the service met all the regulations we looked at.

Enfield Adult Placement Scheme arranges for vulnerable people to live with adult placement carers either on a permanent or short term respite basis. People who use the service may have learning/physical disabilities, mental health needs, older people or young people leaving care. On the day of the inspection there were 15 people using the service.

The service had a registered manager in place at the time of the inspection. 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 and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.

Detailed current risk assessments were in place for people using the service. Risk assessments in place were reviewed and updated regularly. The risk assessments explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person. People were supported to take positive risks.

Medicines were managed safely and effectively and there were regular medication audits in place. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff. Risk assessments specific to medicines were in place for people who were supported to take medicines.

The service maintained sufficient staffing levels and when carers were unable to provide care or took leave, the registered manager ensured care was provided to people with the minimum disruption.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. People lived with the carers in their own homes and excellent comments were received from people, relatives and carers were in relation to the person being part of the carer’s family and having long term relationships. Carers and staff consistently went the extra mile to ensure people led independent and fulfilling lives.

Care plans were person centred and reflected what was important to the person. Care needs are regularly reviewed and updated to meet the changing needs of people who use the service.

We saw evidence of a comprehensive staff induction and ongoing training programme. Staff were also safely recruited with necessary pre-employment checks carried out. Staff had regular supervisions and annual appraisals.

All staff had received training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and staff understood what to do if they had concerns as regards people’s mental capacity. These safeguards are there to make sure that people are receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

People are supported to maintain good health and have access to healthcare services. Referrals are made quickly when concerns are noted as regards people’s health.

Staff regularly met with people and their carers to ensure the service was meeting their needs and they were providing a good service.

The service regularly requested feedback from people who use the service. People also attended service user forums where they had an opportunity to meet other people who use the service, celebrate achievements and feedback on their experiences of using the adult placement scheme.

There was a complaints procedure in place which was displayed for people and relatives. Complaints were logged and monitored for trends and learning points identified were actioned. There was an incident and accident procedure in place which staff knew and understood. There was evidence of audits as regards medication and overall compliance. Issues identified were actioned promptly.

The registered manager enabled an open culture that encouraged staff and people to discuss issues and ideas, though team meetings and service user forums. Adult Placement Officers supported care staff on a daily basis.

The registered manager continually seeked to improve the service and implemented an action plan which identified areas for improvement and actions were put in place accordingly.