SENAD Community Limited - Derby

SENAD Community Limited - Derby provides care and support to children and adults diagnosed with learning disabilities, autistic spectrum disorders, brain injuries and mental health needs living in their own homes. At the time of the inspection they were supporting 36 children and adults locally and in other towns and cities.

Not everyone who used the service received personal care. 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.

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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

The service was exceptional in placing children, people with a learning disability, autism, mental health difficulties and associated complex needs at the heart of the service. It had a strong ethos of providing high-quality and outstanding person-centred care. The management team and staff understood and shared the provider’s values.

The service promoted people's safety, wellbeing and happiness as the top priorities. Effective children and adults safeguarding systems were in place and staff were trained in this area. Comprehensive risk assessments were in place. These were reviewed on an ongoing basis and staff had clear guidance to follow to support people in a safe way, whilst encouraging positive risk taking to promote self-awareness and independence.

Staff recruitment was central to meeting people’s individual needs. People and their relatives were encouraged to be take part in the process to recruit the right staff. This process was robust and ensured individual requirements were met. People were supported by an exceptionally dedicated staff team who understood their needs, had similar interests and upheld the provider’s values. Staff were given time to get to know the individual and to build a relationship based on trust and honesty. This promoted continuity and person-centred care as people developed positive trusting relationships with the staff team.

The staff induction and training programme was comprehensive and tailored around the specific needs of the person they supported and met individual leaning needs. People were supported by very well-trained staff who were supported by a 24-hours management support team to respond quickly to any care emergencies.

People received exceptionally good care because they, their relatives and professionals where required were involved in the assessment and care planning process. Assessments were very comprehensive and covered in detail support needs in all aspects of people’s lives including their current needs, lifestyle choices and aspirations. These were reviewed and updated on an ongoing basis to ensure changes to people’s needs were communicated with staff to promote their wellbeing and independence.

People were supported with all aspects of their health care needs. Staff were trained to support people with their medicines. Where people desired to manage their medicines staff provided the support, guidance and encouragement as required until this was achieved. Staff worked in partnership with other community professionals to provide 'joined up care' to people. This was important for people who needed to access different health care services on a regular basis. Care plans included guidance and advice provided by health professionals to enable staff to support people in an effective and consistent way to promote wellness. This demonstrated the service embraced innovation and learning to improve people's care experiences.

Everyone we spoke with said how passionate the staff and management team were about providing outstanding person-centred care to people when they needed it. They all commented positively about the effectiveness and responsiveness of the support people received. People and relatives thought of their support workers as being like friends or family members who were highly compassionate, caring and flexible. People had achieved excellent care outcomes and feedback from relatives and professionals supported this.

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. Staff empowered people to make informed decisions and enabled them to maintain control and achieve their goals and independence.

The service applied the principles and values consistently of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and to gain new skills and become more independent.

The provider's values were reflected in the way staff interacted with everyone and how they supported people. There was a positive, open and inclusive culture within the service. People received exceptionally personalised care and support, which met their needs, respected their preferences and lifestyles and promoted their independence and wellbeing. People felt they mattered. For example, innovative steps were taken to ensure people’s communication needs were identified and met. Staff received training around specific communication techniques to reduce communication barriers.

Staff roles and responsibilities were clear. Staff were supported and encouraged to use creative and individualised methods to support people to achieve their personal goals. Staff were valued for their contribution. They worked with people, relatives and professionals to continuously enhance people’s quality of life and experiences. Management and staff listened to suggestions and acted on concerns and complaints. All feedback including complaints was used to continually improve the service.

The provider had comprehensive and robust quality monitoring systems and processes in place. Technology was used to identify and affect change to improve the service. People, relatives, staff and professionals views were sought about the service and they were encouraged to comment on new initiatives. The provider and management team worked with other regulators and national organisations to review best practice guidance and training for staff working in this sector. This meant they influenced strategies to improve the care for children and people with a learning disability, autism, mental health difficulties and associated complex needs.

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 5 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from good to outstanding. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SENAD Community Living - Derby on our website at www.cqc.org.uk.

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.

Senad Community Limited - Derby provides care and support to adults diagnosed with learning disabilities, autistic spectrum disorders, and mental health needs living in their own homes.

At the time of the inspection there were 12 people using the service.

The service has a registered manager. This 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.

People and relatives told us this was a caring service. They said the management and staff were kind and approachable and committed to providing personalised and flexible care and support. Staff were recruited to meet people’s specific needs and share their hobbies and interests. People were supported with their cultural preferences and needs which were documented in their care plans.

People felt safe using the service because they had the opportunity to get to know and build up relationships of trust with the staff who supported them. Staff knew how to protect people from harm and gave us examples of this, which included helping a person improve their home environment so it was safe, and assisting another person to make and maintain positive friendships with their peers.

There were enough staff employed to support people safely and enable them to lead full lives. People were involved in choosing their own staff team. Staff were safely recruited to ensure they were suitable to work for the service. People and relatives told us the staff were usually on time for their calls and if they were going to be late they would be informed.

The staff were well-trained and competent. They gave us examples of how they used what they’d learnt from training in their day to day work. These included managing behaviour that challenges the service and dealing with an incident when a person fell. New staff had a comprehensive induction followed by ongoing and refresher training and specialised training where necessary.

Staff worked within the principles of the Mental Capacity Act and ensured that, where possible, people consented to the care and support provided. If people were subject to continual supervision or other types of support that might be deemed restrictive staff ensured this was done lawfully. Staff were open and honest with people and always explained what they were going to do to support them and why.

Staff provided assistance to some people with their meals and drinks. People and relatives told us people were encouraged to choose their own meals and eat healthily. Staff also supported people to maintain good health and access healthcare service when they needed to. They were knowledgeable about people’s health care needs and had specialist training where necessary to meet these. Staff had the information they needed to safely support people with their medicines.

The people and relatives we spoke with said the service was well-led and provided high quality care and support. They told us they had confidence in the registered manager who was approachable, listened to them, and made improvements and changes if they were needed. They said they were regularly asked for their views on the service through questionnaires, phone calls, and in person.

The staff we spoke with commented on how well the registered manager and other senior staff ran the service and told us they always put the people using the service first. They also said that they themselves were well-supported and enjoyed working for a service with such a caring culture.

The provider had systems in place to quality assure the service. The results of the audits we saw showed that people, relatives and staff were overwhelmingly satisfied with all aspects of the service and would recommend it to others.