We carried out this inspection on 5 September 2016 and 12 people were using the service who had mental ill health. Lewisham Adult Placement Scheme provides personal care to people who live with carers who offer 24 hour support in their own homes. The service has a registered manager. 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 were protected from harm because staff were skilled in identifying signs of abuse. Safeguarding processes and policies were in place that assisted staff to protect people from the risk of abuse. Staff knew what actions to take if they suspected a person was at risk of abuse by reporting this to the registered manager or local authority.
Risks to people’s health and well-being were identified by staff. Risk management plans were developed to ensure the risk was managed appropriately and the occurrence reduced. Care and support was delivered by sufficient numbers of staff who effectively met people’s needs. People had regular staff available to them to support them as required because they lived with people who supported them. People were familiar with office based staff who visited them on a regular basis.
Medicines were managed for people appropriately. There were regular checks on people’s medicine administration records to ensure people received their medicines as prescribed. Effective systems were in place for the management, administration, ordering, storage, and disposal of people’s medicines.
The registered provider had support in place for staff who were employed at the service. Staff had access to an appraisal, training, induction and supervision that supported them in their caring role. The registered manager identified the individual training needs of people, their carers and office based staff. Staff understood best practice guidance and training and implemented them.
People gave their consent to care and support. People had information presented to them in a format that they understood so they were able to provided informed consent to receive care and support. The registered manager and staff had an understanding of their responsibilities within the principals of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People’s nutritional needs were met for the maintenance of their health. Meals provided met people’s needs and preferences, in response to their individual needs. Carers supported people to prepare and make a meal of their choice whilst others were able to prepare a meal for themselves independently.
Referrals and appointments were made with health care services to meet people’s needs. Staff followed professional guidance to help people maintain their health care needs. Staff ensured people’s care needs were address when they changed.
People’s personal histories, likes and dislikes were known by people that cared for them. People, carers and their relatives were involved made care and support decisions. Care and support delivered were person centred which included people’s preferences, and choices while respecting their dignity and privacy.
People’s care and support needs were regularly reviewed to ensure their care needs were appropriately met. People were encouraged to contribute to reviews of their care and support to ensure the care provided was appropriate and relevant. People took part in activities of their choice which met their interests and hobbies. People were encouraged to develop their education and employment skills as well as developing new skills. Relationships that mattered and were important to people were maintained as they chose.
The registered provider had a system in place for people to make a complaint. People and their relatives were aware of how to make a complaint or a comment about the service as they chose. The registered manager dealt with complaints in a timely manner and responded to any concerns in a timely manner
The registered manager demonstrated clear leadership and established with staff, a positive culture within the staff team. There were opportunities for staff to be involved in the development of the service for improvements. The registered manager had developed a working relationship with external health and social care staff. This ensured people received the appropriate care and support because they had the support from health and social care professionals who were familiar with them and their needs.