Archived: Voyage (DCA) (Rotherham)

effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were protected against the risks associated with the unsafe use and management of medicines. Appropriate arrangements for the recording, safe keeping and safe administration of medicines were in place.

One person we spoke with explained to us that they took their own medication to work with them. The staff helped them get their medicines to take and they knew when to take them and how to take them. The assessment we saw in their care plan clearly detailed this and showed they were able to understand the need to take their medication.

Is the service effective?

People's health and care needs were reviewed, and health care professionals had been contacted to review medication when required.

Is the service caring?

We observed care workers interacted positively with people who used the service. Care staff and people who used the service were laughing and joking together. At one service staff were painting a summer house and one person was outside with the staff joining in the conversation and activity was inclusive. The person told us they were having a good time.

Is the service responsive?

The manager and regional manager had implemented new systems, policies and procedures following our last visit. These ensured the improvements required were addressed and that the standards continued to improve.

Is the service well-led?

Staff told us they worked very well as a team. They told us they had received competency assessment in regard to medicine administration. They had also had group supervisions to discuss the new systems in place.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Appropriate arrangements for the recording, safe keeping and safe administration of medicines were not always in place.

Staff supervisions, appraisals and training were up to date. This had improved since our last inspection. Staff told us they felt supported and listened to by managers. They said this meant they worked better as a team.

We saw records that staff had followed best interest making decisions where people lacked capacity. Staff we spoke with understood people's capacity and were knowledgeable on the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLs).

Is the service effective?

People's health and care needs were reviewed, and if people were able they were involved in the reviews. The plans of care were detailed and comprehensive. People we spoke with told us they were involved in their reviews.

Is the service caring?

People were treated with respect and staff maintained people's dignity.

We observed care workers interacted positively with people who used the service. Staff showed patience and gave encouragement when supporting people. One person we spoke with told us, 'I like living here the staff are nice.' Relative's we spoke with praised the staff and said the service had improved over the last few months.' This was particularly noted from people who received the outreach service. People told us, 'I get the same carer now and know who is turning up, we have a good relationship.'

We spent time in the supported living services. We saw the experience for people who used the service was inclusive and supportive. We observed staff giving appropriate sensitive support when required. We also observed banter between staff and people who used the service, people were laughing and enjoying themselves.

Is the service responsive?

The provider had implemented a detailed action plan in order for the service to improve following our last inspection. This had been followed and many improvements were seen.

However the medication audits and checks had not identified a number of shortfalls.

Is the service well-led?

The registered manager was the operations manager and had previously not been based at this location, the provider has acknowledged this did not assist the service in ensuring standards were maintained. The provider had therefore appointed a registered manager who was to be based at the location and they were implementing a new staffing structure to support them. The new manager had completed the registration process with CQC.

This inspection was to look at compliance with outcomes 7 and 16. At our inspection in February 2014 we identified serious concerns and issued warning notices. At this visit we found the provider had introduced more effective system to safeguard people and identify, assess and monitor the quality of service provision. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff had received training in relation to safeguarding people who use the service. People using the service told us they felt safe. One person told us: 'I have settled and am happy living here.'

Systems had been implemented since our last visit to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

A new audit system had been introduced to ensure that the service was safely run.

Is the service effective?

People's health and care needs were being reviewed, and they were involved in the reviews.

Audits and reviews had taken place and action plans developed to ensure areas requiring improvement were followed through.

Is the service caring?

We observed care workers interacted positively with people who used the service. Staff showed patience, sensitivity and gave encouragement when supporting people. One person we spoke with told us, 'Its brilliant, I enjoy it and like my support worker.'

Is the service responsive?

The manager and provider had evaluated the last quality monitoring questionnaires and had implemented better systems to ensure the staff met people's needs.

People using the service and relatives told us they felt things were improving and they now felt listened to. Concerns they had raised recently had been dealt with and resolved. However due to previous issues not being resolved at present they did not have full confidence in the provider to maintain this.

Is the service well-led?

The service had evaluated the management and implemented new systems. A new manager was applying to register with us. This would mean the manager would be based at the location. There were new team leaders in post and senior support worker positions were being advertised. This would ensure the service was well led.

There was a new quality assurance system in place that was very detailed and thorough. These ensured shortfalls were identified and resolved.

In general people's needs were assessed and care and treatment was planned in line with their individual assessed needs. However, we found a number of people did not have a plan of care for staff to be able to understand their needs so they could be met, which put people at risk of unsafe care.

People we spoke with were mostly happy with the care they received.

Some people we spoke with who received a service from Options Support were not always happy with the support; this was mostly around staff regularly changing. However the provider has told us there is now a designated staff team so this should not happen.

We carried out this inspection as we received concerning information from the local authority safeguarding team. We conducted this visit jointly with the local authority contracts officer.

We found that medicines were not always recorded or administered safely and appropriately.

Staff did not always receive appropriate professional development. We looked at 12 staff files. We found staff did not receive regular supervisions or appraisals. Staff had not received suitable induction or training.

People who used the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People expressed their views and were involved in making decisions about their care and treatment. People we spoke with told us about their care plan and that they were involved in reviews and updates.

We found that the environment within the supported living schemes was well maintained in a clean and hygienic condition. We also found systems were in place to reduce the risk and spread of infection. Staff we spoke with were fully aware of infection control policies and procedures.

We found there was an effective recruitment and selection processes in place. Staff received appropriate professional development. However some documentation in respect of a person employed was not available at the service.

There was an effective system to regularly assess and monitor the quality of service. We saw audits and quality monitoring was carried out regularly.