The inspection took place on 8, 14 17 and 18 August 2017. We gave 48 hours' notice to the provider as we needed to be sure someone would be available to help with our inspection. This was the first inspection since the service was registered. Real Life Options - Hartlepool is a domiciliary care service and runs support lived services. The service covers Hartlepool and at the time of our inspection there were over 54 people using the service, of which 16 people were receiving personal care.
Real Life Options previously operated care homes in the Hartlepool area. But over the last 13 years they have altered their model of care and now deliver 24 hour care packages for people living in their own home, short visits to provide personal care and services for people with learning disabilities who require support to live independently in the community.
There was a registered manager in post at the time of our inspection who registered with us on 14 February 2017. 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.
Within this vibrant service there was the strong sense of leadership, commitment and drive to delivering a service which improved people’s lives. The culture embedded in the service was one where all the staff were committed to deliver a service that was focused on each person and was responsive to their needs. Relatives and people described the service as being ‘fantastic’ and it delivered a really person-centred approach to care. Person centred is when the person is central to their support and their preferences are respected.
Staff were devoted to the people they supported and we heard they would go the extra mile to ensure people felt valued. Relatives explained how they found their family members’ lives were enriched by contact with the service.
Individual risk assessments were in place to support people with promoting their independence and safety. In addition to individual risk assessments, the service also had a range of environmental risk assessments. People’s support plans were specific and centred around their individualised support needs. Support plans were up to date and were regularly evaluated .Staff knew people and were knowledgeable about people’s care and support needs.
Each person had a care package which set out how many hours support they needed per day. For most people the hours were for staff to support them to learn budgeting, cooking cleaning skills and to join in community activities. For 16 people the level of support included providing personal care.
We found that the provider and manager had encouraged staff to constantly think about improvements and how to make the care delivery more effective. The management style had led to constant constructive review of the service and continuous improvement.
We found that in the supported living services small teams of staff worked with people provided sufficient cover for holidays and absence. The people who received care packages of periods of time during the day reported that on the whole staff turned up on time. People told us the office staff were very approachable and committed to providing an excellent service.
Staff knew people well and understood how to support them and maximise their potential. The service's vision and values ensured people’s rights to make choices were promoted. Staff told us they were committed to ensuring people lived a dignified and fulfilled life. They were flexible in adapting the way they provided care ensuring they were person centred. People told us that staff treated them with dignity and respect and supported them to be as independent as possible.
The service had safe systems in place to ensure people were supported with managing their medicines appropriately. People were supported with promoting their health and nutrition.
Records within staff files demonstrated proper recruitment checks were being carried out. These checks include employment and reference checks, identity checks and a disclosure and barring service check (DBS). A DBS check is a report which details any offences which may prevent the person from working with vulnerable people. They help providers make safer recruitment decisions. Staff were supported with regular training opportunities that linked to the care and support needs of people living in the service.
Staff received mandatory training in a number of areas, including food hygiene, which assisted them to support people effectively. Staff were supported with regular supervisions and appraisals. None of the people lacked capacity to make decisions about their care but staff understood how to ensure people’s rights under the Mental Capacity Act 2005 were protected.
People who used the supported living services were assisted to carry out health and safety checks within their own homes.
Staff had a comprehensive understanding of safeguarding and how to whistle blow. The service had emergency plans in place and took action when they became aware someone was at risk. Staff safely managed medications. People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. People using in the service and their relatives were provided with information to support them to raise any concerns or complaints they may have.
The manager closely monitored the performance of the service. The service had a quality assurance system which included a range of internal checks and audits to support continuous improvement. Action plans were put in place to address any shortfalls in service provision and to demonstrate how areas of improvement were addressed.
We found there was a culture within the organisation of striving for excellence and assisting all to reach their maximum potential. The provider routinely praised staff and ran carer of the year awards, which the people who used the service voted on. They also ran regular competitions such as the 25th anniversary competition, which people who used the service participated in.