Archived: Voyage (DCA)(Lincs) Also known as Ancaster Mews

Voyage (DCA) (Lincs) is a supported living service providing personal care to people with learning disabilities or autistic spectrum disorders and physical disabilities. At the time of the inspection the service was supporting 12 people at two separate locations in Sleaford.

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.

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

The Secretary of State has asked the Care Quality Commission (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.

No restrictive intervention practices were used.

The service applied the principles and values 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 independence.

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 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. However, the records relating to decision-making were not always in place or completed to a consistent standard. We made a recommendation to improve practice.

There were enough care staff to meet people's needs. We received mixed feedback regarding the deployment of sufficient numbers of staff to meet people's needs. One person said, “There has been a lot of agency staff but there is always someone I know on duty.” The registered manager was actively seeking to recruit staff at the time of the inspection. Staff were recruited safely, and their backgrounds checked before they started working in the home.

An effective system was in place to manage medicines. People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people's health, safety and welfare had been assessed, recorded and plans put in place to reduce these.

People were supported to lead their lives in their chosen way. Staff engaged with people to enable them to follow their preferred hobbies and interests.

Staff were observed to be respectful and caring towards people. They understood the importance of promoting equality and independence. People's dignity and privacy were maintained by staff.

People and their relatives were involved in the planning of their care. Their care records contained good detail of their personal preferences and choices.

People could choose their meals and were supported to maintain a balanced diet to suit their needs..

Staff supported people to access appropriate healthcare services, including annual health reviews.

Peoples environments were well maintained and met people's needs appropriately.

Information was available in a variety of formats to help people understand. Staff told us they knew people's preferred methods of communication which was recorded in care records.

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

Rating at last inspection

The service was rated as Good. (Last report published 16 January 2017).

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.

The service provided care for people as part of a supported living arrangement at two locations in Sleaford. There were 10 people using the service on the day we inspected.

At the time of our inspection the service did not have a registered manager. However, we had received an application for a new manager to be registered and the appropriate checks to ensure the person had the appropriate knowledge and skills were being undertaken. 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.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had understood their responsibilities under the Mental Capacity Act. People’s abilities to make decisions had been assessed and appropriate support had been provided to ensure that their views were taken into account when making decisions.

There were enough staff to meet people’s needs. Staff training and the ongoing support staff received from the manager meant that the care provide was calmly delivered, safe and effective. Staff knew how to safeguard people from situations and people where they could be abused. Safe recruitment practices ensure that staff were safe to work with people using the service.

Care plans contained information on the care people needed and the risks they faced. However, at times the information did not always reflect the latest care people needed. However, staff we spoke with were up to date regarding people’s care needs. People had been supported to access healthcare professionals when needed and their care and communication needs were communicated to those looking after them if they had to go into hospital.

Medicines were safely stored and administered. However, recording of when medicines had been administered was not consistently completed. People received person centred support to make choices about their food. Staff knew about people’s nutritional needs and ensured that the food provided was presented in a way which was safe for people to eat.

There was a good relationship between people using the service and staff. Staff supported people to be involved in their care and to make choices about how they spent their time. Wherever possible staff encouraged people’s independence and supported them to access the local community.

The manager was approachable and took action when any concerns were raised. They had gathered the views of people using the service, their families, healthcare professionals and staff. Systems used to monitor the quality of care provided were effective and the provider and manager kept up to date with changes in legislation and best practice.

We spoke with a relative of a person who used the service. They told us, 'The staff are always respectful. Whenever the staff come into the bungalow, they always knock on the door because it is (name) home. The staff are lovely and very caring.'

We asked the staff if Ancaster Mews were responsive to the needs of the people who used the service. One member of staff told us, 'Yes I think we are but I would like to take them out more. I think sometimes we let them down in not being able to get them out enough.'

One person who used the service told us, 'I feel safe because I can ring the bell at night for emergencies and the staff come to help me.'

We spoke with one person who used the service and their relatives and asked them whether they thought the food and drink provided met their or their family member's needs. A person who used the service told us, "The food is nice, my favourite is fish and chips with mushy peas.'

Staff confirmed they had received regular supervision and told us they felt well supported by their manager. We saw records of regular supervision in the three staff files we looked at. Supervision provides a formal way for staff and their manager to discuss any concerns they may have, request training and support and discuss how to carry out their roles.

People who used the service, their representatives and staff were asked for their views through a survey and where possible they were acted upon. The meetings for the people who used the service were called 'One Voice Meetings' and were held monthly. Records of these meetings showed that people were asked about issues affecting their daily lives such as leisure activities, day trips, holidays, key workers, menus and shopping. They were also asked if they had any concerns or problems with the service provided.

When we visited the service we spoke with three people who lived there. Two other people we observed could not communicate with us verbally, however we observed how staff cared for them and we saw by their non-verbal form of communication they were happy and well cared for.

Most of the people lived in a self contained bungalows where staff provided support and care to them. Two of the bungalows accommodated two people. They had their own bedrooms and shared the lounge, kitchen and bathroom. One person lived in a rented property in the community and staff provided domiciliary care.

One person we spoke with told us they really liked living there and said the staff provide good support and care whilst promoting their independence. Another person told us staff treated them with dignity and respect. We spoke with a relative who told us, "The care is excellent, the staff act on everything we say. I have no complaints, people are definitely safe there."

Care and support levels were worked out according to people's needs and abilities. Some people had staff supporting them 24 hours a day. People were given choices about their day to day lives within a risk managed environment.