Archived: Care Management Group - 289 Dyke Road

289 Dyke Road provides personal care in a supported living setting for up to 11 people living with a learning disability and/or autism. At the time of the inspection, nine people were receiving a service. 289 Dyke Road is a large, detached house and communal facilities include a sitting/dining area, kitchen, laundry facilities and access to gardens. Staff provide people with the regulated activity of personal care at all times of the day and night.

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. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

The service had not been consistently well-managed since the last manager de-registered in September 2018. However, interim arrangements had been implemented so that overall oversight of the service was maintained by a manager from one of the provider’s other services. The provider and senior management team were aware of the issues in relation to the management of the home. Audits identified similar concerns to those found at this inspection. Care plans and risk assessments for people had not been regularly updated or reviewed. Staff had not had regular supervisions in recent months. The new manager, supported by the provider’s senior managers, had taken action to address the shortfalls found at inspection. Within a week of the inspection taking place, all care plans had been reviewed and updated and all staff had received a supervision.

People were involved in all aspects of the service and made suggestions on how the service was run. They were encouraged to make decisions relating to their care and support; their independence was supported and promoted. 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.

Before people came to live at the service, a period of transition enabled them to experience what it was like before they moved in. When new people were referred by a local authority, the existing service users met with them and gave their feedback.

People were supported by kind and caring staff who had received training and understood their roles and responsibilities. Care plans provided information about people in a person-centred way. People planned how they wanted to spend their days. Some undertook voluntary work and one person worked in a shop. People were encouraged to live a healthy lifestyle and staff supported them in menu planning and cooking. People had access to a range of healthcare professionals and services.

People were protected from harm by staff who understood what actions to take if they suspected any form of abuse. Risks to people were identified and assessed as needed with guidance for staff which was followed. There were enough staff to support people and additional staff were available when people wanted to go out during the day or in the evening. Medicines were managed safely.

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 September 2016).

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 as required. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People, their relatives and healthcare professionals were positive about the quality of care and support provided to people at the service. One person told us, “There is always somebody to help me. Staff come and talk to us to see what’s wrong. They are very good to talk to and have a conversation.” People were supported to identify goals and to work towards achieving greater independence. The registered manager involved people, relatives and healthcare professionals to ensure people received the support they required. One health and social care professional gave us the following feedback, “The support I witnessed for the service users was exemplary and tailored towards their individual needs allowing them as much freedom and responsibility as possible.”

Staff had detailed knowledge of people’s needs and had the skills to provide support effectively. The registered manager carried out regular supervision sessions and appraisals. Staff felt well supported and understood their roles and responsibilities to ensure a quality service was given. Staff understood how to manage risks to people’s health and welfare and supported them to develop and reach their full potential. Staff had sufficient guidance on positive management of behaviours that may challenge the service and others which protected people’s dignity and rights.

The provider and registered manager actively sought people and their relative’s views and listened and acted on their ideas. People and staff celebrated achievements and milestones, including birthdays and cultural calendar events. People were involved and contributed to the recruitment process of potential staff.

Staff supported people with the values of dignity and respect. Support plans contained thorough and well documented assessments of people’s individual needs and the support they required. People received their care and support as planned and as they wished.

Staff understood how to protect people from possible harm. There were sufficient numbers of appropriately skilled staff on duty meet people's needs. One person told us, “There’s always someone around for a chat or to help.” A relative said, “I think the staff are fantastic and supportive but on a couple of occasions activities have had to be cancelled due to staff shortages. [My relative] doesn’t cope with short notice changes but occasionally they are unavoidable.”

People were supported with their nutritional needs and encouraged to adopt healthy lifestyle choices. Staff ensured people accessed healthcare services for advice, treatment and support. People continued to acquire new skills and gain confidence in living their lives as independently as possible. One person told us, “We do our own separate shopping and cook separate meals.” People took part in activities they enjoyed and were encouraged to try new experiences based on their individual interests, hobbies, preferences and abilities.

People, their relatives and healthcare professionals said the registered manager promoted a person centred approach to care and support. They were complimentary about the registered manager who they said demonstrated strong leadership and provided a hands-on approach to the support people received. One person said, “[The manager] is nice and it’s a happy place to live.”

The provider and registered managed effectively used the audit systems in place to continually monitor the quality of the service and had action plans in place to further improve the support people received and management functions of the service. The registered manager monitored incidents and accidents and put plans in place to prevent recurrence. They responded to and followed up complaints in line with the provider’s guidance. The provider used a robust recruitment procedure which ensured people received support from staff vetted as suitable to work with vulnerable people.

We spoke with two people who use the service and two parents of people who use the service. People we spoke with told us they were happy with the care and support they received and that they were helped to be as independent as possible. One parent told us that "staff are lovely and very caring. I'm very happy with the care and support." Another parent told us "there are no problems whatsoever. He is looked after very well and is able to do some things on his own."

During our visit we saw that people were engaged with activities in their local community and more widely outside of the organisation and that they were supported in the development of their social, communication and life skills. We saw that people who use the service attended various activities including college, swimming, a community allotment, yoga, local clubs and were members of music groups/bands.

Staff we spoke with told us they were happy with the quality of care and support they were able to give people and that they felt supported to do this. One worker told us "I really enjoy the work. It is very enabling for people and they're able to be more independent." Another worker told us "I love working here."