Catherine Tam Agency

Updated 19 June 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: One inspector completed the inspection.

Service and service type: Catherine Tam Agency provides personal care and support to three people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate the premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: We gave the service 24 hours’ notice of the inspection site visits because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 8 May 2019 and ended on 9 May 2019. We visited people’s homes on 8 May 2019 and the office location on 9 May 2019 to review care records and records relating to the management of the service.

What we did: Before the inspection we reviewed information available to us about this service. This included incidents the provider must notify us about, such as abuse and we sought feedback from the local authority and professionals who worked with the service. We assessed the information we require providers to send us at least once annually via their provider information return (PIR). The PIR provides key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection, we spent time with all three people who the Catherine Tam agency supported. We spoke with the nominated individual, who was also the owner, the registered manager, the team leader (project manager) and three support staff. We also spoke with the clinical lead, a trainer and the office manager. We looked at people's care records and documentation about the management and running of the service.

After the inspection site visits we spoke to another support worker and a relative.

Updated 19 June 2019

About the service: Catherine Tam Agency is a domiciliary care agency. It provides personal care services to people living in their own supported housing. It is registered to provide support for people living with a learning disability or autistic spectrum condition, mental health needs or physical disability. At the time of the inspection three people were being supported.

People’s experience of using this service: The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. For example, people's support focused on them having choice and control over the care and support they received and as many opportunities as possible to become more independent.

People were exceptionally well supported by staff who genuinely cared about people. People were supported to be in control of their lives and make their own decisions.

People were supported to take positive risks. Healthcare professionals were involved in decision making so risks were minimised and emotional well-being maximised.

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.

Innovative ways were used to support people’s involvement in recruiting the right staff. Matching tools were used to make sure staff had not only the right skills and experience to support people, but also the right interests and personality characteristics so positive and trusting relationships could be built. People chose who supported them to which activity or event so they were able to have the best experience possible.

Medicines were managed in a safe way whilst also giving people as much independence and control as possible. People had attended medicines training alongside their staff team and training was also open to people’s relatives to support and enhance their confidence.

Staff training was exceptional and involved training deemed mandatory by the provider, which included emotionally led training which supported the development of empathic relationships with people. Staff were encouraged and supported to attend additional training, such as music in care practitioner training and mindfulness training as this supported the culture of the organisation.

A holistic approach to assessing people’s needs was used which included their physical and mental health as well their hopes and aspirations. People’s needs were continuously assessed and there was a focus on future planning to ensure staff could meet people’s needs into the future as well.

People were encouraged and supported to have a healthy lifestyle, including a balanced diet, with new food experiences and taking part in exercise. People attended regular health check-ups and were supported to access external healthcare professionals including GP’s, and dieticians, opticians and dentists.

Staff had used their shared interests and personality characteristics to form strong emotional bonds with people. There was clearly mutual respect between people and staff which fostered an environment where people’s rights were valued and upheld. Staff treated people with kindness and compassion and relationships were also filled with fun and laughter. There was clearly shared humour amongst everyone we met.

Creative ways were used to people at the heart of planning their care and achieving their goals and aspirations. Support plans were incredibly specific to the person and included information on people’s histories and the reasons why people needed to be supported in particular ways. There was also a focus on what people’s future needs would be and how they could continue to be supported in their current home by staff who knew them well.

People were supported with a range of activities from voluntary jobs and entrepreneurial ventures to keeping chickens, going to the theatre, going to football matches and spending time with family and friends. Anything people suggested to staff that they would like to do was taken on board and staff enthusiastically supported people to make this come true.

There was an absolute focus on ensuring the governance of the service was used to enhance the quality of the service, so people could live the life they wanted. The registered manager and team leader continued to support people, so they could maintain positive relationships and act as role models for staff.

All staff understood their role as being to support and empower people to be active citizens who were in control of their lives, took positive risks and who were valued and accepted by society.

Partnership working was used to raise awareness and develop the creative and innovative ways staff used to enhance people’s lives. Work had begun to achieve accreditation with Opening Doors London as a ‘Pride in Care’ provider. This aimed to raise awareness and support Lesbian, Gay, Bisexual and Transgender people to life happy, healthy lives, free from loneliness prejudice and discrimination. The provider also worked with other key speakers and trainers to enhance people’s lives, raise awareness and act as role models for other providers.

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

Rating at last inspection: Good. (Report published 14 November 2016)

Why we inspected: This was a scheduled inspection based on the previous rating of good. The service has improved its rating from good and has now achieved outstanding in four key questions.

Follow up: We will continue to monitor the service and complete a further inspection in line with the rating of outstanding. If any information of concern is received, we may inspect sooner.