PBS4

This service provided care and support to 23 people living in ‘supported living’ settings, so that they can live as independently as possible. People ranged from younger adults to older people living with a learning disability and associated conditions, such as autistic spectrum disorders.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

The leadership of the service demonstrated an outstanding commitment to engaging with people, stakeholders and the local community, to promote positive outcomes for people. They helped raise awareness and understanding of people’s needs in their local community, supported local provider’s in best practice and contributed on a national level, in helping to promote best practice in learning disability care.

The leadership team played an active role in the day-to-day care and support people received. They had systems in place to monitor the quality and safety of the service and listen to people’s feedback and concerns.

People and relatives were happy with the care they received from the provider. People were treated with dignity, respect and as individuals. Their care focussed on helping them to live full and active lives in the community, whilst building skills and increasing their independence.

The provider had established positive working relationships with stakeholders to meet people’s complex needs. People’s needs were assessed and reviewed in line with best practice. Their care plans reflected their preferences, routines and ways in which staff could help keep them safe.

People were supported with their healthcare and nutritional needs. The provider worked with people to overcome historical anxieties around accessing healthcare services. This resulted in positive outcomes for people’s health.

Staff had received training in line with people’s needs and were appropriately supervised in their role. Staff understood people’s needs and were motivated to provide good quality care. There were enough staff in place, who had been subject to appropriate recruitment checks to ensure they were suitable to work with people.

People and relatives told us they were fully involved in decisions about their care and that any complaints or feedback would be listened to by the provider.

The provider met people's communication needs and helped them contribute towards making decisions about their care. 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.

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

Rating at last inspection

The service was rated good at our last inspection (report published 4 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager at the service. 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.

The registered manager was committed to ensuring that the service was inclusive and focussed on the needs of the people using the service. The service was governed by an independent board, which had representatives from people who used the service and relatives. This helped the service make sustainable and appropriate choices about how the business grew. The registered manager and enablement director played a prominent role in the day-to-day running of the service. There was a complaints policy in place, the registered manager investigated and relayed findings back to relevant parties in accordance to this policy.

Most people and their families were happy with the communication from the service. Family members told us they were kept informed about important events or incidents when they occurred. People told us the management of the service had stabilised and the level of communication with families had improved.

There were sufficient staff available to meet people’s needs. New staff went through a robust recruitment process, which helped determine their suitability for the role. People and their families told us they were involved in selecting their own staff. The service was in the process of recruiting additional senior staff. Staff received a training programme, which was in line with nationally recognised standards and received additional training to support people’s individual needs.

The registered manager monitored staff performance through support and supervision. Staff performance was measured against their knowledge and application of people’s care plans. This helped the registered manager appraise staff’s performance and set areas for improvement. Staff had received training in safeguarding and understood how to put this training into practice in order to help to keep people safe.

Risks to individuals, including those caused by heightened anxieties were assessed and managed effectively. Where people were involved in incidents, these were analysed to look for triggers and possible ways in which they could be prevented from reoccurring.

People’s care plans were focused on building people’s life skills. People and their relatives helped to develop care plans and were involved when they needed to be updated. People and their families were able to leave feedback for staff, using the service’s computer based daily recording system. This enabled the service to respond to any suggestions or changes required to people’s care plans.

Staff followed legislation designed to protect people’s rights. People were cared for with kindness and compassion by staff that understood the importance of obtaining consent and following legal guidelines where people were unable to consent.

People received their medicines as prescribed and safe systems were in place to manage medicines safely. The service had an emphasis on ensuring that ‘when required’ medicines were taken only when necessary to help ensure people’s safety. Staff had worked with people to manage their anxieties and reduce the need to take these medicines as frequently.

People were encouraged to access healthcare services. The service focused on helping people to access doctors, dentists and other health professionals, even if they had previously been reluctant to do so. The service worked collaboratively with healthcare professions, which benefitted people’s well-being.

Where people required support with their eating and drinking, staff were aware of the help people required. People were encouraged to participate in choosing their meals and the preparation of their food. Appropriate support was in place to encourage and guide people to follow appropriate dietary requirements to help keep them safe.

The registered manager monitored the quality of the service using a quality assurance system. This focused on whether the service was meeting the outcomes identified in people's care plans. The registered manager also invited an external company to assess the safety and quality of the service. They used this feedback to make improvements to the service.