Options Kernow

Updated 1 December 2018

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 announced inspection of Options Kernow took place over three days between 18 and 24 October 2018. The provider was given short notice so arrangements could be made to enable us to visit people at home. The inspection was carried out by one adult social care inspector.

We reviewed the Provider Information Record (PIR) and previous inspection reports before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also reviewed the information we held about the service and notifications of incidents we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we visited two people at home and spoke with another person by telephone. We also spoke with three people’s relatives, six members of care staff, the deputy manager and the registered manager. Feedback was also received from two health professionals who had previously worked with the service. In addition, we inspected a range of records. This included three care plans, four staff files, training records, staff duty rotas, meeting minutes and the service’s policies and procedures.

Updated 1 December 2018

We carried out this announced inspection on 18, 23 and 24 October 2018. The service was previously inspected in April 2016 when it was operated by a different provider and was found to be good in all areas. At this inspection we again rated the service as Good.

Options Kernow provides personal care to people living in their own homes in the community. It is a supported living service which aims to support people to live 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. At the time of our inspection the service was providing support to 12 people with a learning disability living in Cornwall. Each person was supported by a team of staff for up to 24 hours per day.

People felt safe and well cared for by staff who’s company they enjoyed. People told us, “I am happy living here”, “[The staff] are nice to me” and “The staff are very good. I can have a laugh with them.” People’s relatives were also complimentary of the support the service provided and commented, “[My relative] is safe, [they] are very well looked after”, “The staff are wonderful, conscientious and caring” and “[My relative] likes them.”

All staff had completed safeguarding training and understood their role in ensuring people were protected from harm, all forms of abuse and discrimination. Staff were confident any concerns they reported to their managers would be addressed.

Each person was supported by a dedicated team of staff who they knew well. We found that the service employed sufficient staff to meet people’s needs and records showed planned levels of support had been achieved. There were appropriate systems in place to ensure people needs were met during unexpected periods of staff absence and staff told us “If someone phones in sick someone else comes in within a couple of hours.” The service only agreed to provided additional packages of care where suitable staff were available.

Staff were well trained and knew how to meet people’s support needs. All new staff completed comprehensive induction training which included the care certificate. All training was updated and staff told us, “The training is very good” and “They give you plenty of training.”

Care plans provided staff with sufficient guidance to enable them to meet people’s support needs. These documents were designed to help staff to provide consistent support. Care plans included details of the level of support people normally required with specific tasks and activities. Information about people’s life history hobbies and interests was included along with background information on the person needs to enable staff to provide personalised support. People and their relative’s had been involved in the development and review of care plans. We were told, “I made my own guidelines up, They do what I want them to do” and “I am involved in the care plan reviews.” Staff said people care plans were accurate and up to date and commented, “The care plans are very good” and “The care plans are very informative they are the first point of call. They are kept up to date.”

Risk assessments had been completed and clearly identified the actions staff must take to ensure people’s safety. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. Where people were at risk of becoming anxious or confused staff were provided with details of events and incidents likely to cause anxiety and guidance on how to support people to manage these issues. All staff had completed training in positive behavioural management techniques and staff told us, “We are trained in positive behaviour management techniques but we very rarely use it. Only when necessary to keep people safe. I think we have only had to use it twice in the last two years.” Relative were confident these techniques were used appropriately and told us, “Very rarely do they have to help [my relative] away from situations.”

All accident and incidents that occurred were documented and reported to managers for further investigation. Records showed all incidents had been appropriately investigated. This included the identification of any changes or improvements that could further ensure people’s safety and prevent similar incident from reoccurring. Staff told us, “They are very good at reflective practice. We have a full de brief in response to any incidents to identify anything that could have been done better.”

Staff and managers understood the requirements of the Mental Capacity Act 2005 (MCA). Where people lacked capacity in relation to specific decisions these had been consistently made in the person’s best interest with appropriate involvement from relatives and health professionals. The service had recognised some people’s care plans were potentially restrictive and was working with Cornwall Council to have these plans authorised by the Court of Protection.

The service had robust recruitment practices, which meant it only employed staff who were suitable to work with vulnerable people.

The staff team were well motivated and took pleasure in supporting people to live as independently as possible. There comments included, “I am very proud to work here”, “It is one of the best places I have worked. They really do try to live up to their aims. I would rate it 10 out of 10” and “I think this is one of the top places I have worked. It really is supported living.”

Staff were well supported by the service’s managers and records showed all staff had received regular supervision and annual appraisals. Staff told us, “I get supervision quite regularly”, “The managers are very good. I like the system here. We see the deputy manager pretty much every week and she does hands on observations” and “The managers are absolutely brilliant. They are very supportive.”

There were effective quality assurance systems in place designed to drive improvements in the service’s performance. Managers completed monthly audits of all aspects of care and the provider's operations manager had completed an assessment of the service’s performance in relation to the Care Quality Commission’s five key questions. Where any issues had been identified action plans had been developed to address and resolve these.

The service had system in place for the management and investigation of complaints and records showed all complaints received had been appropriately resolved. Relative told us they thought they would not be subject to any form of discrimination if they raised complains about peoples care and told us any issues were, “Resolved efficiently and very quickly by senior management.”