Deaconstar Limited

Deaconstar Limited provides personal care and support to people living in ‘supported living' settings across Bishop Auckland, so that they can live in their own home as independently as possible. The service provides support to people with a learning disability and/or autism. At the time of our inspection there were 18 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Medicines were given safely but some systems needed review to ensure best practice was always followed. We have made a recommendation about medicines. 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. Some documents relating to people’s mental capacity required update and the registered manager had contacted relevant parties to start this process. The service had plans and guidance to support people with identified risks. Care was person centred and promoted choice and independence. People were supported to achieve positive outcomes. People were supported by staff who received an induction and ongoing training.

Right Care:

People received kind and compassionate care. Feedback from people and their relatives was all positive. Some relatives told us staffing had improved and people had more consistent staff teams. Staff knew people well, understood and responded to their individual needs. Staff promoted and respected people's right to privacy, dignity, and respect. Staff knew how to protect people from the risk of harm and abuse. People were fully supported to live a life of their choosing and to increase their independence.

Right Culture:

The registered manager listened to concerns and promoted a positive culture that was person-centred, open, and inclusive. Concerns and complaints were listened and responded to. Staff were supported and given opportunities to feedback about the service. Quality assurance processes enabled continuous improvement. As the registered manager had not been in post long some systems and processes were still in development, but plans were in place and being acted on. There was a learning culture and learning was shared. There was good communication with partner agencies to support people’s health and wellbeing.

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

Rating at last inspection

The last rating for this service was Good (published 6 March 2018).

Why we inspected

This inspection was based on the length of times since we last inspected.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Deaconstar Limited on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation in the safe key question in relation to medicines management. Please see this section for further details.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We last inspected the service in January 2016 and rated the service as Good. At this inspection we found the service remained Good and met all the fundamental standards we inspected against.

Deaconstar Limited provides care and support to 20 people living in six ‘supported living’ settings across Bishop Auckland, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The service provides care and support to people with learning disabilities and many people also accessed the provider’s day service based at the registered location site.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place. 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. At the time of our inspection the registered manager was on holiday so we met with the provider.

Staff and the management team understood their responsibilities with regard to safeguarding and had been trained in safeguarding vulnerable adults. People we spoke with told us they felt safe living in their homes.

Where potential risks had been identified an assessment had been completed to keep people as safe as possible. Accidents and incidents were logged and investigated with appropriate action taken to help keep people safe. Health and safety checks and meetings to discuss safety were completed and procedures were in place to deal with emergency situations.

Medicines were managed safely and administered to people in a safe and caring way.

There were sufficient numbers of staff on duty to keep people safe and the provider had an effective recruitment and selection procedure in place.

Staff received the support and training they required. Records confirmed training, supervisions and appraisals were up to date and forward planned. Staff told us they felt supported by the management team at the service.

People’s needs were assessed before they started using the service and were continually assessed in order to develop support plans.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported with their dietary needs and meals were planned weekly based on people’s likes and dislikes and specialist support had been sought where needed.

People who used the service were complimentary about the standard of care and support at the service. People were involved in making decisions about their care and the home they lived in, and were supported to be independent where possible.

The service was moving to a more person centred care plan approach and had changed their risk assessment template to reflect this. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account. The provider told us they planned to take forward this work to ensure care plans were to the same person centred content.

People accessed a wide range of activities and people were supported with employment and learning opportunities.

The service had good links with the local community and local organisations.

People and staff were positive about the management of the service. The registered manager and provider had a daily presence at the service.

The provider had an effective complaints procedure in place. People who used the service were aware of how to make a complaint and met together regularly with the staff team to talk about issues about the house, staff team and living together. Feedback systems were used to obtain people’s views about the quality of the service.

We last inspected Deaconstar on 9 April 2014, at which time it was meeting all our regulatory standards.

Deaconstar is a small domiciliary care provider based in Bishop Auckland providing personal care to people in the Durham area. It provides support to people with learning disabilities. It is registered with the Care Quality Commission to provide personal care. During our inspection we found the service provided personal care to 21 people.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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. The registered manager had extensive experience of working with people with learning disabilities.

We found the service had in place a range of risk assessments to ensure people were protected against a range of risks as soon as they started using the service.

People who used the service, relatives and external healthcare professionals expressed confidence in the ability of staff to ensure people were safe. No concerns were raised from relatives, external healthcare professionals or local authority commissioning professionals.

We found that there were sufficient numbers of staff on duty in order to meet the needs of people using the service and that staff rotas corresponded to the levels of support required by people.

There were effective pre-employment checks of staff in place and effective supervision and appraisal processes, with all staff we spoke with confirming they were well supported.

We found staff were trained in core areas such as safeguarding, as well as training specific to the individual needs of people using the service, for example diabetes and abdominal massage. We found staff had a good knowledge of people’s likes, dislikes, preferences and communicative needs.

In this regard the service used recognised specialist tools and detailed care plans to ensure staff were best able to communicate with people who were unable to verbally communicate. The service provided some documentation, such as questionnaires, with pictoral prompts intended to help people with learning disabilities, although the service user guide had not been adopted into an easy-read format.

People with specialised diets were supported through detailed and thoughtful meal planning through liaison with specialist nurses and a dietitian.

We found care plans to be person-centred and in sufficient detail so as to give members of staff a range of relevant information when providing care to people who used the service. These care plans were reviewed regularly and with the involvement of people who used the service, relatives, healthcare professionals and, where applicable, advocates.

The registered manager displayed a good understanding of capacity and the need for consent throughout care practices. We saw people had been supported to receive the support of an advocate.

People’s changing needs were identified and met through close liaison with a range of external health and social care professionals.

The service had in place strong community links with the police and other organisations and we saw the registered manager and other staff took a pro-active approach to continuous service improvement. Staff, people who used the service, relatives and other professionals praised the openness and responsiveness of the management of the service.