3L Care Limited

People’s experience of using this service:

A holistic approach had been adopted in the assessing, planning and delivery of people’s care and support. Care plans were extremely detailed and identified intended outcomes for people. Staff provided excellent care and support that was met in a way people preferred and provided consistent and positive outcomes that exceeded expectations. Staff worked hard to provide a consistently better quality of life for people by supporting them to develop in areas such as communication, social interaction, education and independence. Family members spoke highly of the support provided and told us how their relatives had achieved improvements in their own abilities, independence and confidence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; promotion of 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 were supported to live enriched lives and do what they chose. Staff encouraged them to be as independent as possible whilst ensuring they remained safe. Risks that people faced were identified and assessed and measures were put in place to manage them and minimise the risk of harm occurring. Staff showed a good understanding of their roles and responsibilities for keeping people safe from harm. Medicines were managed safely and people received medication at the right time. Family members told us they felt extremely confident their relatives were safe.

Positive relationships had been developed between staff and people using the service. There was laughter and warmth within the service and staff spoke positively about the people they supported. Family members spoke positively about the caring attitudes of staff and told us their relatives were well looked after. Staff treated people with dignity and respect and made sure personal information was kept private.

Staff showed a genuine motivation to deliver care in a person-centred way based on people’s preferences. The management team and staff had developed strong, familiar and positive relationships with people and family members. Throughout the inspection the management team and staff were observed to be warm and affectionate towards people and often displayed physical contact that was appropriate and accepting from people. Family members described staff as being extremely caring and that the service ‘went the extra mile’ for people to ensure they lived a good quality life.

The leadership of the service promoted a positive culture that was person centred and inclusive. Family members and staff all described the management team as supportive and approachable. The management team showed a continued desire to improve on the service and worked closely with other agencies and healthcare professionals in order to do this. Effective systems were in place to check on the quality and safety of the service and improvements were made when required.

Rating at last inspection: Good (report published 6 September 2016)

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

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

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

The service was registered in November 2014 and had not previously been inspected.

The service is registered to provide accommodation and personal care and support to a maximum of six people, and at the time of the inspection they were at full capacity. The service offers support to people with complex health needs, acquired brain injuries and physical and learning disabilities. It is located a short distance from the centre of Winsford.

A manager was in post who had been registered with the CQC since December 2014. The registered manager was supported by another manager who was based onsite and helped with the day-to-day running of 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.

Staff had received training in safeguarding and knew how to recognise the signs that may indicate abuse is taking place. The registered provider had a safeguarding policy in place, and staff were clear how and who to report their concerns to.

There were sufficient numbers of staff in place to meet people’s needs. People’s relatives told us that they had never seen the service short staffed. The registered provider had robust recruitment measures in place to ensure that staff were of suitable character and skill. This included checks by the disclosure and barring service (DBS), and obtaining references from previous employers.

People were supported to take their medication by staff who had been trained in the safe administration of medicines. Medication was stored securely, and appropriate records were in place to document when these had been administered.

Staff had received training and support which enabled them to carry out their roles effectively. Staff demonstrated a good understanding of the roles and responsibilities in relation to the MCA, and people were offered choice and control over their care needs. This ensured that people’s liberties were protected in accordance with the law.

People received the necessary support during meal times, and there were clear instructions in care records for staff to follow around this. Charts were in place to monitor people’s nutritional and fluid intake, where they were at risk of weight-loss. People were supported to access health and social care professionals where required. This ensured that people’s health and well-being was maintained.

Positive relationships had been developed between staff and people using the service. Throughout the inspection there was a lot of laughter and warmth, and staff spoke positively about the people they supported. The service had received a number of compliments from outside agencies about the staff. The staff team had won ‘best care team’ at the national care awards in 2015 due to their work with people using the service.

People were frequently supported to engage in activities, both outside and inside the service. There were examples of people going Kayaking, out for walks and there had been a recent holiday to Blackpool. This demonstrated a compassionate approach, and also ensured that people received the social stimulation they needed.

The registered provider had a complaints policy in place, and people’s relatives felt able to complain. There was an easy read complaints policy in place for people using the service, however no complaints had been received. The registered manager was aware of how to access the local advocacy service, to support people with decision making, and we saw that one person had the details of their advocate pinned to the notice board.

Staff and people’s relatives told us that management were approachable and supportive. There were clear lines of accountability in place, and staff knew who to report to if they had any concerns. There was a process in place for learning from any issues that may have occurred. Information around any issues was cascaded to staff so that they were aware of risks, and how to prevent these occurring in the future.

The registered manager and the registered provider carried out audits and quality checks of the service to ensure that standards of care were maintained. This included checks on care records, the environment and infection control. Follow up action had been taken in response to any issues identified within a timely manner.