19 October 2018
During a routine inspection
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
This unannounced inspection took place on 19 and 23 October 2018. This is the first Care Quality Commission (CQC) inspection since the service reregistered on 10 November 2017. There were 12 people using the service during our inspection.
There was a registered manager in place. 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.
Staff knew how to protect people from risk and harm and how to report concerns. Information was provided in different formats, including assistive technology, to help enable people to understand how to report any incidents of harm. Staff identified any accidents and incidents that happened and quick action was taken. Learning was shared with other staff, to reduce the risk of it happening again.
People’s care records were held securely to ensure confidentiality. Risk management plans provided detailed information for staff on how to reduce and monitor the risks to people’s health and welfare. People were having their medicines as prescribed. Staff were working with external health professionals and current guidance to try to reduce the number of medicines people were on.
An advocacy service regularly supported people to make sure their needs and wishes were communicated and listened to. People were provided with pictorial guidance and other communication tools to involve them in decisions about their care and support. These various methods helped staff, alongside the person, plan the review of each person’s care.
Staff were flexible and responsive to people’s individual needs and preferences. Often finding creative and innovative ways to help people live a full a life as possible.
People lived busy social lives and took part in a wide range of interests, including volunteer work that helped promote their confidence and well-being. Engagement in activities and support networks outside of the service was an important part of people’s lives. Staff enabled people to take a key role in the local community and were always looking to build further links.
Staff promoted, maintained and developed people’s independence and living skills as far as practicable. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People received a kind and compassionate service from staff who knew their care and support needs very well. Staff maintained people’s privacy and dignity when supporting them with their personal care. Staff respected people’s equality and diversity. Staff assisted people, where needed, with their drinking and eating to help people’s well-being.
People’s wishes, ideas, suggestions and concerns were listened to, respected, and acted upon. Staff proposed additional suggestions about how people wanted to spend their leisure time that people themselves may not have considered. This made people feel empowered and valued. The registered manager and staff worked hard to be innovative in providing person centred care based on best care practice and current guidance. People were put at the heart of the service. Compliments about how the service was run and care delivered were received from relatives of people using the service.
People received external health professional support that helped them achieve their goals and aspirations. Personal protective equipment was in place for staff to maintain infection prevention and control when supporting people.
When people became end-of-life staff would work in partnership with other healthcare professionals to ensure people’s care was dignified and comfortable.
People were involved in the recruitment of potential new staff. Required checks to make sure new staff were of a good character and were considered suitable to support people safely were carried out. Staff were trained to meet people’s care and support needs and development opportunities were in place for staff to increase their skills and knowledge. Supervisions and competency checks were in place to monitor and develop staff.
People, their relatives, representatives, and staff were involved and enabled to make suggestions to improve how the service was run. Audit and governance systems were in place to monitor the service, to drive forward any sustained improvements required. The registered manager and their staff team linked up, communicated and worked with other organisations to ensure people’s well-being. This was when they were using different services and, or moving between services.
Further information is in the detailed findings below.