Archived: Masons Hill

At our last inspection of the service on 15 June 2015 the service was rated good overall and outstanding in well led. At this inspection on 7 September 2017 we found the service was now Outstanding in responsive and remained Outstanding in well led. It is now rated Outstanding overall. It continues to be rated Good in the other key question areas.

The same registered manager remained 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.

At this inspection we found the service was outstanding in empowering people to have as much control over their lives as possible and achieve to the maximum potential. People’s care was noticeably consistently personalised to their needs. Relatives told us they felt the service was highly personalised and that the staff team worked well to deliver an excellent level of care. Feedback from health and social care professionals commented on the very personalised care provided. We observed there was a strong culture of supporting and promoting people’s strengths and diverse needs. The service had been nominated by the local authority for awards in successive years; including one of the provider’s social inclusion awards.

People had a personalised, assessed and written plan of support which they were involved in making. There were regular key worker sessions to consider any changes to the support provided and to encourage people to set and work towards their goals and ambitions. This plan reflected their needs and was in a format that enabled them to understand the plan for their care more effectively. People were provided with a range of suitable activities to encourage social inclusion and develop life skills.

The leadership of the service remained rated outstanding. The feedback from people, health and social are professionals continued to be overwhelmingly positive and distinctive. The local authority had nominated the registered manager and the service for a manager’s award. The staff team commented on how well the registered manager ran the service and was a positive role model and leader. The registered manager maintained a strong culture of respect, inclusion and empowerment for people at the service. The service had an open approach to feedback and sought the views of people, their relatives and professionals on a regular basis to consider any changes that needed to be made.

The Chief Executive took an active leadership role in encouraging and monitoring services to develop distinctive personalised care, promote choice and increase social inclusion. There were a number of initiatives to promote people's well-being which included running specific training courses, an annual sports event and annual awards ceremony. The provider held events to encourage closer working with families and encouraged a culture of continual learning and development for staff and families through events that involved professionals and experts in their field.

There were systems to monitor the quality of the service and identify any areas for action. Staff felt well supported in their roles. People, their relatives and professionals were regularly asked for their views in a number of different ways and the registered manager considered any improvements that could be made.

People and their relatives said the staff team remained very caring and kind, and, we observed warm and positive relationships. People were treated with respect and dignity and were involved in decisions about their care. People continued to be asked for their consent before care was provided and staff were aware of their responsibilities under the Mental Capacity Act (2005) and DoLS. Staff received a range of suitable training and support to carry out their roles.

People’s dietary needs were met and their independence was encouraged. People had health care plans in a format they could understand. The service continued to work closely and proactively with health professionals to ensure people’s changing health needs were addressed.

People and their relatives told us they remained safe and well supported at the service. Support workers had received training on safeguarding adults, so they could recognise the signs of possible abuse. Accidents and incidents were safely managed. There were robust arrangements to deal with a range of emergencies if needed. Possible risks to people were identified and guidance was in place to reduce risk. The service also maintained a positive attitude to risk taking to enhance the quality of people’s lives. People continued to receive their medicines when they should and staff had received training on the safe administration of medicines. Adequate staffing levels were maintained to meet people’s needs and the provider followed safe recruitment policies.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them, another professional and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who could express their views told us they felt safe. Staff were knowledgeable about safeguarding procedures and knew the signs to look out for that may signal abuse. Staff had received relevant training on managing and preventing challenging behaviour and there were strategies in place to reduce the risk of this where relevant. Risk assessments were in place for example to reduce any risk when travelling in the community.

There was an up to date recruitment policy in place and arrangements were in place to make appropriate checks on staff before they started work at the service. Staff were provided with a range of training to enable them to provide safe effective support.

Is the service caring?

We spoke with four people who used the service. They all said they were happy with the support provided. One person told us 'The staff are there if you need anything and they will help you', another person told us 'This is perfect for me, you can have a joke with the staff and other people but you can get peace in your own flat.' A third person told us 'The staff all do a good job here, they listen to what I say.'

People received effective care and support from staff who were familiar with their individual needs and preferences. People using the service had personalised support plans which were current and outlined their agreed care and support arrangements. Health needs and potential risks had been identified and plans were in place to reduce possible risks. This meant staff had the information they needed to meet people's individual needs.

We saw that people were engaged in a wide range of activities in the community throughout the week and that they were encouraged to be as independent as possible.

Is the service effective?

We saw there were up to date policies and procedures in place. There were also easy-read versions of policies available for people using the service to enhance their understanding.

There were a range of methods in place to obtain the views of people at the service such as key worker sessions, tenants meetings and annual surveys. People at the service told us they felt listened to and their views respected.

A care professional told us they felt the service had built a good relationship with a person who used the service who was unable to communicate verbally. They felt staff were able to meet their needs effectively through detailed support plans.

There was a system in place to ensure new staff received induction training and that all staff training was kept up to date.

Is the service responsive?

We found that risk assessments were reviewed at frequent intervals and changes made if needed. Support plans were reviewed with people who used the service. The registered manager had responded to an increase in incidents of challenging behaviour by seeking advice and organising further training for staff on positive behaviour support. Since then, we saw there had been a reduction in the incidents.

There were a range of quality assurance mechanisms in place such as service audits by the provider and specific audits by the registered manager, for example health and safety audits. We saw that areas identified for action had mostly been addressed.

Is the service well led?

We found that the service was proactive in looking for opportunities for integration in the community and that people were encouraged to be as independent as safely possible. Goals were set in agreement with people at the service to improve their quality of life.

Relatives we spoke with told us they thought the change of provider and the registered manager had brought improvements for their family members. They felt able to approach the registered manager if they had any issues. Regular meetings were held with relatives to enable them to express their views.

Staff told us they were supported through regular supervision and staff meetings which helped to improve consistency in practice and allowed them to share ideas.