KEYFORT North East

People’s experience of using this service: People told us they felt safe with the staff who supported them. Staffing capacity was sufficient and staff deployment was effective to ensure people's needs were met in a safe, timely and consistent way.

All people were complimentary about the care provided by support staff. They trusted the workers who supported them. They said staff were kind, caring and supportive of people and their families.

The service assisted people, where required, in meeting their health care and nutritional needs. Staff worked together, and with other professionals, in coordinating people's care.

Systems were in place for people to receive their medicines in a safe way. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

Records provided guidance to staff to ensure people received safe, person-centred, appropriate care and support. Information was accessible to involve people in decision making about their lives.

Communication was effective and staff and people were listened to. Staff said they felt well-supported and were aware of their responsibility to share any concerns about the care provided.

People were involved in 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. The policies and systems in the service supported this practice. Information was accessible to involve people in decision making about their lives.

There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns. The registered manager undertook a range of audits to check on the quality of care provided.

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 (29 September 2016)

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection.

Follow up: We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. If any concerning information is received, we may inspect sooner.

Neuro Partners North East (Neuropartners) is a provider of domiciliary care and nursing services. They provide support for people with acquired brain injury or other complex needs. Their office is located in Gateshead but they provide support across the North East and Yorkshire. There were 25 people using the service at time of this inspection.

The service had a registered manager who had been in post since 2013. 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 advised us they were intending to de-register and appoint a new registered manager as part of a re-organisation of the management structure of the service.

We found that people’s care was delivered safely and in a way of their choosing. They were supported in a manner that reflected their wishes and supported them to remain as independent as possible. Where people’s needs could not be met safely or effectively, work was either declined or specific staff were recruited and trained to meet that person’s needs.

Where the registered manager had identified issues relating to the quality of communication they had taken steps to ensure this issue was addressed. Staff also told us that supervisions were not happening as frequently as their policy stated. Again the registered manager was taking action to review supervision processes and ensure they were useful to staff development.

People’s medicines were managed well. Staff watched for potential side effects and sought medical advice as needed when people’s conditions changed. People and their family carers were supported to manage their own medicines if they wished.

Staff felt they were well trained and encouraged to look for ways to improve on their work. Staff felt valued and this was reflected in the way they talked about the service, the registered manager and the people they worked with.

People who used the service were matched up with suitable staff to support their needs, and if people requested changes these were facilitated quickly. People and relatives were complimentary of the service, and were included and involved by the staff. They felt the service provided met their sometimes complex needs.

There were high levels of contact between the staff and people, seeking feedback and offering support as people’s needs changed quickly. People and their relatives felt able to raise any questions or concerns and felt these would be acted upon.

When people’s needs changed staff took action, seeking external professional help and incorporating any changes into care plans and their working practices. Staff worked to support people’s long term relationships. People thought that staff were open and transparent with them about issues and sought their advice and input regularly.

The registered manager was seen as a good leader, by both staff and people using the service. They were trusted and had created a strong sense of commitment to meeting people’s diverse needs and supporting staff. External professionals felt that people’s needs were supported effectively by a holistic service.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

An assessment of people's care and support needs was carried out before people started to use the service. This was to ensure staff had the skills and had received the training in order to meet the person's support requirements. One support worker told us, 'There is mandatory training, but we also get training which is specific to service users' particular needs, or conditions.'

Risk assessments were in place. People were supported and encouraged to maintain their independence and this was balanced with the risk to the person. Audits were carried out and accidents and incidents were monitored and the appropriate action was taken to keep people safe.

Records confirmed that the provider carried out effective recruitment and selection procedures to ensure that suitable staff were employed by the service.

People using the service told us they felt safe with staff who provided their care and support. One person told us, "I feel safe with the staff who come here to help me." Relatives we spoke with told us they were confident that their family members were safe with the staff providing care and support. Relatives' comments included, 'I have absolutely no concerns about his care or welfare. He's happy; he'd tell me if he wasn't,' and 'She'll always be vulnerable, but I have no concerns with Neuro Partners staff.'

People were protected from the risk of infection because appropriate guidance had been followed. People were cared for by support workers who received regular training on infection control, health and safety and food hygiene and they had access to personal protective equipment. The provider had detailed policies in place to provide staff with specific advice and guidance for staff regarding infection issues, cleaning products and potentially hazardous substances that could be encountered when providing care.

Is the service effective?

People and their relatives we spoke with were very complimentary about the service provided. People commented how helpful and caring the workers were. One person told us, 'They are very good; I wouldn't be able to do a lot of things without their help and support.' Another person said, 'My family live out of the area, but they keep my relatives informed when I go into hospital and alert my family to come and visit me.' Relatives told us the service kept them up to date with what was happening with their relative's care and they felt able to ask any questions. One relative commented, 'I am involved in every decision making process.'

Staff we spoke with were knowledgeable about people's care needs. They told us they were introduced to a person before they started to work with them and received enough information to ensure they provided individual care and support to the person. One relative told us, 'The staff handle him very well. They know him and can read him ' they know what type of day he is having; whether it's good, or bad and can make adjustments to suit.' People who used the service told us they were nearly always seen by the same staff who knew them and their needs well. One person commented; "I get the same support workers all the time. They arrive on time and never leave early and I book different support days each week and they are flexible and fit in with my life and arrangements.' A relative commented, 'She has two to three regular staff who are all sensitive and discreet.'

Staff said there were excellent training opportunities and their training was refreshed when required.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. All people and relatives spoken with talked highly of the level of care provided by staff. One person told us, "My support worker is really good. I've never had any problems and all of the staff are very good. I feel well supported and the staff are friendly and easy to get on with." A relative commented, 'He likes them and their interaction with him is very good. He gets the right kind of support.'

Staff were matched with people who required a service to ensure they were compatible and shared the same interests, where possible, with the person who required care and support. Support workers were introduced to the person before they started to work with them and they received detailed information to ensure they provided safe and effective care. One person told us, 'They are really good at matching support workers with people. My main person is great; I get on really well with them'

Is the service responsive?

People's care records were reviewed regularly to make sure that the information was accurate and up to date. Where people's needs had changed, their care plans were updated more frequently. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

We saw that people were encouraged to retain as much control over their lives as possible. People and their relatives were complimentary about the services provided and the support given for people to remain independent in their homes, community or workplace and to pursue leisure interests and educational opportunities.

Regular meetings took place with staff to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people who used the service.

People and their relatives knew how to make a complaint if they were unhappy. We saw that three complaints had been recorded, investigated and resolved to the satisfaction of the complainant during 2014.

Is the service well-led?

The service had a registered manager who had had been in post since November 2013 and the provider had in place systems to monitor the quality of the service people received.

Staff had a good understanding of the aims and objectives of the service and quality assurance processes were in place. People were able to complete a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. One person commented, 'They pick their staff well; they all seem well trained and competent.' This helped to ensure that people received a good quality service at all times. The provider undertook regular audits and risk assessments to monitor the quality of the services. There were effective systems to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Staff, people who used the service and their relatives said communication was good. People who used the service had regular contact from office staff to check their well-being and the quality of service provided by support staff. This was in the form of telephone calls and home visits by managers. This provided opportunities to discuss the person's views of the service they received, the way care was provided and any areas of improvement.

Staff received regular supervision and appraisal and told us they felt supported by the management team. A member of the management team was available on call for advice and support and in case of emergencies. Support worker's comments included, 'I feel 100% supported by the management. I know I can contact my line management at any time and I can pick up the phone and ring X (registered manager) at head office,' and 'I feel supported by my line management. They are always available for advice if I have any issues, or concerns and we have regular staff meetings which are good to talk about things and make changes and improvements.'

We found people's needs were assessed and people were involved in developing their care plans. People who used the service and their relatives told us staff supported them to become more independent and involved in their local communities.

We found the provider had systems in place to ensure people were protected from the risks of abuse. Staff had a good understanding of the safeguarding policy.

Staff said they had excellent relationships with their managers and had the opportunity to work towards additional qualifications. We found the provider was unable to provide sufficient evidence to show staff received appropriate and consistent supervision and appraisal.

People told us they were asked for their views about the care they received. We found the provider undertook a range of audits to ensure care was delivered to an appropriate quality and standard.