Courage Limited

Updated 26 January 2024

Date of assessment 13 February 2024 – 19 March 2024. An assessment has been undertaken of a specialist service that is used by autistic people or people with a learning disability. We expect health and social care providers to guarantee autistic people and/or people with a learning disability 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 assessments and judgements about services supporting people with a learning disability and/or autistic people. We considered this guidance where people using the service have a learning disability or are autistic. We identified 3 breaches of the legal regulations in relation to safeguarding, safe care and treatment, and governance. Systems and processes to safeguard people from the risk of abuse were not robust. We found incidents that met the threshold for a safeguarding concern were not always shared with the local authority and CQC. Risk assessments were incomplete and did not include risks we identified during our assessment. We found no evidence people had been harmed. However, risk management of people’s care required improvement. People’s medicines were not always administered safely. The systems in place for the management and oversight of the service were not always effective. Improvements were required to recruitment and staff deployment. The registered manager had not ensured safe recruitment practices were being followed. Staff did not always attend care visits within the time they were expected. Staff training records did not reflect staff had received all the training required to carry out their role.

Updated 26 January 2024

The service is a domiciliary care agency, the model of care and setting did not always maximise people’s choice, control and independence. People told us they were not always provided with safe care; risks and medicines were not always effectively managed. People provided mixed feedback about how staff supported their independence and supported them to have choice and control over their own care. People told us they met with staff before care commenced to discuss their care needs and staff asked for their consent before providing care. All people had not received a regular review of their care needs. Care was not always person-centred and did not always promote people’s dignity, privacy and human rights. We received mixed feedback about the timing and consistency of people’s care visits. The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using the service were supported to lead confident, inclusive and empowered lives. People provided mixed feedback about how the provider responded to their concerns to ensure the service was meeting their needs.