1, 2 September 2014
During an inspection in response to concerns
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Due to the complex needs of some of the people using the service we used a number of different methods to help us understand their experiences. This included observing how staff supported people, speaking with staff and checking records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they felt safe. However, whilst staff had received training to ensure people who used the service were safeguarded from harm, a recent internal investigation by the provider indicated staff understanding about their roles and responsibilities concerning the reporting of incidents would benefit from further development.
Individual support plans were available for people who used the service, to help staff provide assistance with meeting their needs. However, we found these were not always fully completed or contained enough information about their needs, which meant staff may not know how to support them effectively. We found there was no member of staff present in one of the projects to enable flexible support to be provided and ensure people's needs were appropriately met, which posed a potential risk to the people who used the service.
We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to the planning and implementation of people's support to ensure they were safeguarded from harm and ensure there were enough staff available to meet their needs.
Is the service effective?
Whilst people's support plans contained information using pictures and words, to help them understand and be involved in decisions about them, there was limited evidence of meaningful engagement with people to ensure they were able to fully participate in this process.
Is the service caring?
People who used the service told us they felt their rights and dignity were respected. We observed care staff interacted with people in a positive manner demonstrating compassion and a commitment to meeting their needs. People told us they felt comfortable and trusted the staff.
Is the service responsive?
People told us they would speak to staff if they were unhappy with the service provided. Some people however told us they were unsure whether they received all their agreed amount of support to enable their skills to be fully developed. We were told that communication with professionals in the community could be improved to enable there involvement with the service when this was required.
Is the service well-led?
We were told the transitional arrangements of the new parent company were not yet fully completed and that policies concerning the provision of the service were still in the process of being agreed, which meant staff may be unclear about their roles and responsibilities.
There was a system in place to enable the quality of the service to be assessed and enable the acting manager and staff learn from previous events. However there was evidence this needed further development, following transition from the previous company to the new provider, which meant people were at possible risk of harm.
The service did not have a manager who was correctly registered with the Care Quality Commission. Whilst the acting manager had submitted notifications about incidents, we found these had used the previous provider's details.
We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to management and checking systems to identify, assess and manage potential risks to people and enable their health, safety and welfare to be promoted.