Consensus Community Support - Northamptonshire

Consensus Community Support Limited is a supported living service providing personal care to adults with learning disabilities, autism and other complex needs. At the time of the inspection 24 people were being supported.

People lived in their own accommodation either in a flat within a complex, a house with shared communal areas or a flat or bungalow in the community.

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

People continued to benefit from an excellent well-led service providing outstanding care, extremely responsive to meeting people’s individual needs. People were at the heart of everything and played an active role in shaping their own lives.

Staff were highly motivated to support people to achieve their goals and aspirations. Staff spoke fondly of people and were proud of what they had achieved. There was a real ‘can do’ attitude. Staff were well trained and very well supported to develop their skills and knowledge which benefitted the people they supported. They were innovative in their approaches and thought ‘outside the box’ to help people achieve their goals.

The feedback from people and their families was overwhelmingly positive with a consistent theme that people felt cared for and empowered to do what they wished. People were involved in the recruitment of staff and took control as to which staff were suited to support them with the various activities they undertook.

People were treated as individuals and were valued and respected. They were involved in monitoring and maintaining quality standards within their own homes. The staff ensured that people’s privacy and dignity was protected and spent time getting to know people well.

The registered manager led by example and ensured staff appointed shared their ethos of providing good quality care and support, valuing staff for their individuality and what they could bring to enhancing people’s life experiences. They actively sought feedback from people, their families and staff to continually look at ways to improve the service and were receptive to ideas and suggestions.

The systems in place to monitor the quality and performance of the service were highly effective and the provider was quick to address any shortfalls identified.

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 services supported this practice.

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.

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 Outstanding (published 6 May 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.

There was a registered manager in post. 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 service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the registered manager. The service put people’s views at the forefront of the service and designed the service around their needs. People were given every opportunity to be involved in the running of the service and to provide their opinions and feedback about what they wanted.

People were safe using the service. Staffing requirements were assessed in an innovative and dynamic way following consultations with people that used the service. The rotas reflected the support people required to maintain the choices they had made, and as a result the staffing arrangements were flexible to meet those needs.

People played a significant role in supporting the management to recruit the staff that were most suitable to provide the care and support people required. This included people interviewing staff and having trials with them to ensure potential new staff members had the right values and ethos to provide the standard of care people required.

The provider took a thorough approach to protect people from harm. They empowered people who used the service to understand and recognise if their care was not at an acceptable standard and that they could feel safe to report this. Staff were supported to understand safeguarding in a wider context, particularly with regards to institutional safeguarding and staff were confident they would report any matters of concern.

Staff received training that had been personalised to meet the needs of the people that used the service and the management team identified and utilised the strengths of the staffing team. A specialist group of staff were used by the service to help support people with behaviours that could harm themselves or others. They provided advice and guidance to staff within the service to give them new skills and strategies to keep people safe.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People’s nutritional needs were assessed and regularly monitored. People took as much control over their nutrition as they were able and staff supported people to learn and understand the importance of this.

People were treated with care, compassion and great kindness. Staff had an empowering and empathetic attitude to support people’s personal development, and each person was supported in a way that was individual to them.

The registered manager recognised the importance and value of good advocacy and went above and beyond expectations to encourage people to speak openly and honestly. The service recruited internal advocates to help support people who used the service, and also used an external advocacy service to offer people an independent person to help them make decisions. People were encouraged to identify and value their own support networks in order to improve their independence but showed a caring approach if people were in distress. People’s diversity and individuality was celebrated and people were encouraged and able to share private or vulnerable matters with an open and empathetic staff group.

Comprehensive assessments were made before people began using the service, and existing people who used the service were invited to meet new people to consider if the service was right for them. People’s care packages were completely person centred and designed around each person’s individual needs, styles, preferences and values. The format of each person’s care plan was designed by each individual and this helped to break down barriers with new staff or people as people were keen to share what they had created.

People made great progress whilst they used the service and people were encouraged to discover and achieve their short term, medium term and long term goals or dreams. People reacted with pride and disbelief at some of the goals they had achieved and the staff and management were also very proud at what people had achieved.

Without exception, there was a person centred approach to everything the service offered and how it was run. People’s choices were at the forefront of the service and people were encouraged to be involved and have a say about matters that could have an impact on them.

The service employed Experts by Experience to capture a true perspective of what it was like to receive the care and support from the Consensus team and this was truly valued by the service. There were robust quality assurance systems in place to ensure the service was providing good quality care and where minor improvements had been identified these had been acted on.

A person told us that staff were good at their jobs. She said; ‘’staff help us. I could not ask for better’’.

We spoke with the relatives of six people. They all told us that care was very good.

One relative said; ‘’the one to one care is good. However, staff turnover is far too high. It means my son has to start all over again with someone new which is frustrating for him’’.

This was a mixed inspection. People we spoke with thought care staff were caring. This was also the view of their relatives. The essential standards we inspected were met, except for staff always being supported. We have asked management to ensure comprehensive staff training is put into place, that induction for new staff is thorough to enable them to provide safe and effective care at all times, and that staff supervision is regularly provided to all staff.

There were suggestions made; for management to look at ways of making sure that care workers stayed in their jobs, so that consistent care was provided to people.

A person told us that staff were: ‘’really good. They help me when I need them‘’.

We spoke with four relatives. They all told us that the care provided was of a high standard and that staff were always friendly.

One relative said; “staff are fantastic. They help my sister in every way possible’’. Another relative said: ‘’the service is very good and all staff are very caring’’.

One relative said that she had found one agency worker who did not have understandable English language skills. The manager said that she would follow up this issue.

One relative said that she could not remember having received a questionnaire from the service, asking for her views. The manager said that there was evidence in place to show that questionnaires were supplied to all relatives.

This was a positive inspection. People said that they were very satisfied with the service. The relatives we spoke with also said the service provided was of a high standard. The service also complied with standards relating to respecting and involving people in the service, meeting the care and welfare needs of people, ensuring that people were safeguarded from abuse, they ensured that staff were properly checked, and that services were properly monitored to meet people's needs.