8 November 2017
During a routine inspection
We inspected Turning Point Oxfordshire on 8 and 14 November 2017. We gave the service 48 hours’ notice of the inspection to ensure the registered manager would be in the office. We also needed to let people know we wanted to visit them in their homes to review their support.
The service had a registered manager. 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.
People receiving support from Turning Point Oxfordshire received highly individualised person centred care. Support plans contained detailed and personalised care plans and we saw that many people had been supported to have a full and meaningful life enjoying interests and gaining employment. People benefited from a large range of activities and interests provided, to ensure they were kept occupied if they chose. There were many excellent opportunities to optimise people's social and stimulation requirements.
There was clear guidance for staff on how to meet people’s individual needs and support them to achieve their goals. We saw that people were relaxed and staff demonstrated a caring attitude. The service had ensured people’s communication was maximised which assisted an increased understanding and reduction of distress.
As the values and vision of the organisation and service had been integrated into everyday practice, people living with learning disabilities were able to achieve what they wanted in their lives and overcame obstacles to achieve positive outcomes.
People and their families, where appropriate, were fully involved in the development of their care planning along with health and social care professionals and Turning Point staff.
The service was outstandingly well-led. The service actively promoted a positive, inclusive and open culture. The structure of the service worked for people, so that locality managers were always available to support staff and people when needed. The service worked in conjunction with other organisations to improve care, such as participating in research and engaging in external initiatives working towards improving standards and developing the service further. There were robust quality assurance systems in place which monitored the service, identifying potential areas for improvement, and actions were taken to improve these.
Staff were highly motivated and worked as a team and shared a common ethos of providing high quality, compassionate care with regard to people's individual wishes and support needs. Staff were valued, well-supported and supervised by the management team.
Staff knew how to keep people safe, and how to report any concerns. There were enough staff to keep people safe. People received their medicines as they had been prescribed, and the service was undertaking an initiative to review medicines regularly, with a view to decreasing psychotropic medicines use.
Risk to people was identified promptly and effective plans were put in place to minimise these risks, involving relevant people, such as relatives and other professionals. Where risks were more complex, comprehensive guidance was in place to guide staff, including the most effective approaches to use, or particular communication methods suited to the individual. Guidance was in place for staff so that they could mitigate risk, and support people to take sensible risks as safely as possible.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had followed the Code of Practice in relation to the Mental Capacity Act 2005 (MCA). We observed staff treated people as equals and individuals, offering them options whenever they engaged with them. Staff always endeavoured to enable people to maintain their independence and to make their own decisions.
People's privacy and dignity were highly respected, and this also was reflected in the detailed guidance provided within people's care records.
People were supported to follow healthy diets, and this had a positive impact on their wellbeing. They were also supported to access healthcare services when they needed to.