Archived: Affinity Supporting People Limited

Affinity Supporting People Limited is a domiciliary care agency. It provides personal care to people living in their own homes and provides care and support to people living in 11 ‘supported living’ settings, so that they can live as independently as possible.

The service provides support to adults living with mental health needs, a learning disability or an autistic spectrum disorder.

At the time of the inspection, Affinity Supporting People Limited was providing a service to 98 people. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. 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 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.

The Secretary of State has asked CQC to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service and what we found

People were provided with an excellent person-centred service which was very responsive to their needs, wishes and preferences. The overarching value of the service was, “Your Life, your way”. Throughout the inspection, we saw numerous ways of how this value was implemented and embedded into the ethos of the service to provide excellent outcomes for people.

Management and staff had an extremely positive impact on people's lives and went above and beyond to understand and respond to people's needs and preferences. They supported people's ability to express themselves and included their wishes and aspirations in support planning and activities. The service had taken a key role in the local community. Staff were actively involved in making contact with community resources and support networks to ensure people had access to a broad range of meaningful activities which improved their quality of life, developed their self-confidence and their self-esteem.

We saw excellent examples of where partnership working had improved people’s independence, safety and wellbeing, and met their needs and aspirations. 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. Detailed risk assessments followed best practice guidance and included positive risk taking to optimise people's opportunities to engage in activities.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People continued to be safe and protected from the risk of abuse and avoidable harm. Staff were observed to be kind and caring. People were supported respectfully in ways that upheld their dignity. Excellent communication strategies ensured people had been supported to express their views.

The service was well led by a committed and skilled management team who led by example. They used effective checks and audits of care to provide high-quality, person-centred care. There was an ongoing plan of development for the service. The staff team were well trained and supported, and communication was good.

The provider followed their recruitment procedure which ensured all staff were safely employed. Induction training was thorough and the training for staff was kept up to date which meant they could provide effective care.

People's needs had been thoroughly assessed and their support plans included input from families and community-based professionals. People's health needs were identified, and they were supported to maintain regular appointments and screening. People were supported to eat and drink. Specialists were involved when required for people who were nutritionally at risk.

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

Rating at last inspection

The last rating for this service was Good (published 15 November 2016).

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.

Affinity Supporting People is a domiciliary care service. The service provides flexible personalised care and support for people with learning disability who require additional support to live independently within the community. The agency's office is located in the centre of Accrington Lancashire.

At the last inspection on the 11 January 2014. The service was found to be meeting the regulations applicable at that time.

At the time of the inspection 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.

Feedback we received from people using the service, their families and staff members was very positive, they indicated that staff were caring, supportive and understood people’s needs well. Family members told us they had seen positive changes in their relatives who appeared to have grown in confidence, independence and happiness as a result of being supported by the service.

The provider had robust processes in place to maintain a protected and suitable environment for all people using the service and visitors. Risk assessments were established to identify any risks associated with areas such as the storage of medicines, sharps and substances hazardous to health (COSHH).

Suitable training was offered to staff to ensure they were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify the relevant authorities when required.

The service had satisfactory staffing levels to support the operation of the service and provide people with safe and personalised support. Comments from people using the service, their relatives and staff supported this. Staff were expected to access a variety of training which ensured they were skilled and experienced in safely and effectively supporting all people using the service.

Recruitment procedures were thorough and robust. Appropriate steps were taken to verify new employee's character and fitness to work. People using the service and their relatives were very much a part of the recruitment of staff. Staff induction processes contained the correct amount of detail to provide them with the knowledge to carry out their support role effectively and an appropriate level of training was offered to all staff. This ensured staff were equipped with the correct knowledge to support people effectively. People spoken with and their relatives told us how staff knew their needs well. Staff shared their knowledge with us and demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.

The provider had appropriate processes in place for the safe administration of medicines this was in line with best practice guidance from the National Institute for Health and Care Excellence. Staff were adequately trained in the administration of medicines and all medicines were stored securely and safely.

People each had their own individual care file containing support plans and risk assessments individual to their own personal need. These documents gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with these changes.

Staff spoken with were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provided legal safeguards for people who may be unable to make their own decisions. The management team also demonstrated their knowledge about what process they needed to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

We had positive feedback from people using the service, relatives and staff about the management team. People told us they were happy to approach management with any concerns or questions. People felt the registered manager was very supportive and would act on any issues they may have.

We noted the registered manager had previously won two awards in recognition of his work practice. The registered manager commented these awards recognised his desire to be part of the service delivery and going above and beyond his role as a registered manager.

We found the ethos of the service was very much about enabling people to reach their full potential. We saw over the two days of inspection opportunities were offered to people on a daily basis to develop their confidence and gain qualifications and new life experiences. The staff were very much a part of enabling this to happen.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. People who used the service told us they liked the staff who assisted them and they said they felt well cared for.

People we spoke with told us they were happy with the service they received and that staff were always helpful and kind.

Everyone we spoke with said that the staff explained what they were doing and involved them in decisions about their care, and in reviewing their care plans. People said they were given choices about how their care was delivered and that they felt safe and well cared for. One person said: “The staff help me do things like cleaning and cooking and are very respectful”, and another said: “The staff are all ok and they help me to do shopping”. These comments were reflective of the comments we received from the majority of people we spoke with.

The provider ensured that they spoke with and involved other health professionals in providing care for people. The staff understood how to keep people safe and understood their responsibilities for reporting concerns if necessary. The staff were supported by the management to understand how to support people through training and supervision, and there was a system in place to effectively respond to people’s concerns and complaints.

Some other comments people using the service made included;

"My carers look after me really well"

"I have good carers. No problems with the service whatsoever".

"Always ask me what I want or need. Very well run service".

"The staff who support me are very caring people".

People were provided with care plans that are regularly reviewed so that people have the most appropriate support to meet their needs and if these needs change, the support they receive is amended to reflect those needs. People said they felt safe and were able to discuss concerns or issues with the staff if they wished to.

People said they felt safe and were able to discuss concerns or issues with the staff if they wished to. They said they had no concerns about the care being provided and they felt safe and protected from potential harm