Archived: Access Community Services Limited

Updated 10 October 2018

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

This was an announced inspection which took place over two days on 20 and 21 August 2018. We announced the inspection to ensure we could get consent to speak with and visit people in their own homes. The inspection was carried out by an adult social care inspector and an ‘expert by experience’. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert contacted people and their relatives by phone to seek their views.

Prior to the inspection we accessed and reviewed the Provider Information Return (PIR) as we had requested this information prior to the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service.

During the inspection we visited two supported living houses and spoke with five of the people who received care from Access Community Services Limited. On the second day of the inspection we visited the central offices of the service. We also contacted by telephone and received feedback from another two people who used the service and nine relatives.

We spoke with eight staff including care/support staff, two senior managers for the services and the registered manager. We looked at the care records for three of the people being supported, including medication records, two staff recruitment files and other records relevant to the quality monitoring of the service such as safety audits and quality audits.

We spoke with three health and social care professionals who gave us feedback about the service which was wholly positive.

We spoke with eight staff including care/support staff, two senior managers for the services and the registered manager. We looked at the care records for three of the people being supported, including medication records, two staff recruitment files and other records relevant to the quality monitoring of the service such as safety audits and quality audits.

Updated 10 October 2018

Access Community Services Limited is based in Southport, Merseyside and provides personal care and support to people who have learning disabilities, physical disabilities or mental health conditions. The service provides care and support to people living in their own homes including ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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 was an Announced inspection which took place over two days on 20 and 21 August 2018. The service was supporting 45 people within supported living and 52 people in the community; 36 of the total 97 individuals received support with personal care.

We last carried out an inspection of this service in November 2017. This had been a ‘focussed’ inspection where we looked specifically at previous breaches of regulations. We found there had been overall improvements but the service still required to improve some management systems as the provider’s action plan had not been fully met and there were areas that still required development and implementation. The service was rated as ‘Requires improvement’ for the second consecutive inspection.

On this inspection we found continued improvement and more consistent and sustained service delivery. Managers had continued to develop management systems to assess and monitor the service ongoing and the remaining breach of regulations regarding the governance of the service had been met. The registered manager could evidence a series of quality assurance processes. There was a clear management hierarchy and we saw that new ideas and service improvements were effectively developed and communicated.

We rated the service as Good.

The service had a registered manager in post. 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.

We visited two of the supported living houses which were staffed by the care agency. We also spoke with people who were receiving support at their own homes. The observations made and feedback we received evidenced people were getting good support. External professionals involved in peoples care also gave positive feedback which gave further evidence of a good service.

We found medicines were administered safely. Medication administration records [MARs] were completed in line with the service's policies and good practice guidance. We pointed out some anomalies in one ‘house’ we visited concerning safe storage of medications and staff knowledge regarding covert administration of medicines [medicines given without a person’s consent] and both issues where addressed by managers.

There were arrangements in place for checking the care environment to help ensure this was safe. These arrangements included regular checks and audits by house managers which were supported by health and safety audits by senior managers.

People using the service, relatives, professionals and staff told us they felt the culture of the organisation was fair and open and supported good care and support for people using the service.

People we spoke with said they felt safe with the staff from the agency and the support they received. We were told that if any issues arose they were addressed by the managers.

We saw that any risks to care provision had been assessed and there were fully developed plans in place to help ensure they were kept safe. Staff were arranged to support this depending on each person’s needs.

There were sufficient staff available to support people.

We looked at how staff were recruited and the processes in place to ensure staff were suitable to work with vulnerable people. Appropriate applications, references and security [police] checks had been carried out.

The staff we spoke with clearly described how they recognised abuse and the action they would take to ensure actual or potential harm was reported. All the staff we spoke with were clear about the need to report through any concerns they had. We reviewed past safeguarding investigations and it was established that the agency had followed procedures and liaised well with safeguarding authorities. Agreed protocols had been followed in terms of investigating and ensuring any lessons had been learnt and effective action had been taken. This rigour helped ensure people were kept safe and their rights upheld.

We saw that people's consent to care was recorded. The service worked in accordance with the Mental Capacity Act 2005.

Feedback from people and their relatives told us that staff seemed well trained and competent. Communication between relatives, people being supported, staff and senior management was effective.

Staff were supported by on-going training, supervision, appraisal and staff meetings. We found that house managers had been left out of the formal supervision process; managers said this would be reviewed and formalised. Formal qualifications in care were offered to staff as part of their development.

Local health care professionals, such as the person’s GP and the Community Mental Health Team [CMHT] were involved with people and staff from Access Community Services liaised when needed to support people. This helped ensure people received good health care support.

Staff could explain each person’s care needs and how they communicated these needs. People we spoke with and their relatives told us that staff had the skills and approach needed to ensure people were receiving the right care.

We saw that staff respected people’s right to privacy and to be treated with dignity.

All family members and people spoken with felt confident in expressing concerns and complaints. Issues were dealt with and the service was responsive to any concerns raised. An issue raised on the inspection was dealt with appropriately with the services complaints procedure.

The registered manager and the two deputy managers could talk positively about the importance of a ‘person centred approach’ to care. Meaning care was centred on the needs of each individual, rather than the person having to fit into a set model within the service. It was clear that the service was meeting standards outlined in current good practice guidance including ‘Registering the Right Support’.