Mrs Lynne Weatherly

Mrs Lynne Weatherly provides a domiciliary care service to people living in their own houses or flats. The service provides both regular daily visits to people in their homes and some staff members, provide 24-hour support to people. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of inspection three people were using the service.

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.

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’s experience of using this service and what we found

People were safe and protected from avoidable harm because staff knew how to identify and report any concerns relating to the risk of abuse. People told us that they felt safe with the staff.

Risks to people’s health, safety and well-being were assessed, and action was taken to remove or reduce the risks. People were supported by enough staff who had been recruited safely. People's medicines were managed safely. Action was taken when medicine errors occurred. The provider was consulting with the pharmacist to make sure people received their medicines as safely as possible.

Staff had received training in infection control practices and personal protective equipment such as gloves and aprons was provided for them. The provider took appropriate actions following any incidents and learning was shared with staff to prevent re-occurrence.

The provider undertook assessments prior to people joining the service to make sure staff could meet their needs. Care plans were developed from these assessments and staff had clear guidance on how to meet those needs. The provider was in the process of transferring the care plans onto an electronic system.

People said that staff always stayed with them for the allocated time. People knew which staff would be supporting them on a day to day basis. Staff received the training they needed to look after people in the way that suited them best. Staff received support, guidance and advice from the provider. Staff supported people with their nutritional needs to help maintain their health and wellbeing.

Staff and the provider knew people well and quickly identified when people’s needs changed. When people were unwell or needed extra support, they were referred to health care professionals and other external agencies.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. Staff communicated effectively with people and with each other to make sure people's needs were met in the way they had chosen.

People's relatives and other professionals praised the kind and caring nature of staff. People received consistent care from a small team of staff. People's care records were held securely at the providers office and in people’s homes.

People received care and support they wanted and needed. People's relatives told us they would be confident to raise any concerns with the provider and felt confident that they would be listened to. People were satisfied and happy with the care and support they received.

The provide and staff team were committed to providing a high standard of care to the people they supported. They understood their responsibilities.

People, relatives and staff members spoke highly of the provider and told us that they were always available and supportive. People, their relatives and professionals gave positive feedback about the service they received. They said the provider was approachable and sorted out any issues they had. Staff knew their roles and were able to tell us about the values and the vision of the service. There were adequate quality assurance measures in place.

Rating at last inspection:

The last rating for this service was Good – (published on 23 December 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained 'Good' overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re inspection programme. If any concerning information is received, we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mrs Lynne Weatherly on our website at www.cqc.org.uk.

Mrs Lynne Weatherly provides care services from an office in Tunbridge Wells to people in their own homes mainly in the Tunbridge Wells area. The care provided was tailored to people’s needs to ensure people were able to maintain or develop their independence or to support family carers. Care and support was delivered to adults with learning disabilities and autism. Some people required support with day-to-day tasks such as cooking, shopping, social activities, washing and dressing and help to maintain their health and wellbeing. There were three people using the service at the time of our inspection. The care and support people needed ranged from 20 hours a week to more intensive 24-hour care.

Mrs Lynne Weatherly (The provider) was registered with the Care Quality Commission to manage the service as the provider. 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 provider worked as part of the team delivering care to people. People and their relatives spoke about the staff in a positive light regarding their feelings of being safe and well cared for. Staff were trusted and well thought of by people. They thought that staff were caring and compassionate.

The provider assessed people’s needs and planned people’s care to maintain their safety, health and wellbeing. The provider had a clear understanding of people’s needs and how they could enable staff to deliver a high quality of care. Risks were assessed by staff to protect people. There were systems in place to monitor incidents and accidents.

Staff had received training about protecting people from potential abuse and showed a good understanding of what their responsibilities were in preventing abuse. Procedures for reporting any concerns the staff had were in place. The provider knew how and when they should escalate concerns following the local authorities safeguarding protocols.

Staff training covered both core training like first aid and more specialised training in learning disabilities and autism. We could see that the management and staff culture was based on recognised person centred good practice in learning disability care.

The provider and staff had received training about the Mental Capacity Act 2005 and understood when and how to support people’s best interest if they lacked capacity to make certain decisions about their care.

Working in community settings, staff often had to work on their own, but they were provided with good support and an ‘Outside Office Hours’ number to call during evenings and at weekends if they had concerns about people. The service was able to continue to run in the event of emergencies arising so that people’s care would continue. For example, when there was heavy snow or if there was a power failure at the registered office.

Staff were recruited safely and had been through a selection process that ensured they were fit to work with people who needed care and support. Recruitment policies were in place that had been followed. Safe recruitment practices included background and criminal records checks prior to staff starting work.

The provider ensured that they could provide a workforce who could adapt and be flexible to meet people’s needs and when more staff were needed to deliver care, they were provided.

People and their relatives said that staff were well trained and understood their needs. They told us that staff looked at their care plans and followed the care as required. People told us that staff discussed their care with them so that they could decide how it would be delivered.

Staff had been trained to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

The provider gave staff guidance about supporting people to eat and drink enough. People were pleased that staff encouraged them to keep healthy through eating a balanced diet and drinking enough fluids. Care plans were kept reviewed and updated.

There were policies in place that ensured people would be listened to and treated fairly if they complained. The provider ensured that people’s care was individualised to them and in some cases, people had written their own care plans.

The management team and staff were committed to the values of the organisation and ensured they took these into account when delivering care and support.

The quality and effectiveness of the service delivery was based on a range of current policies that the provider kept up to date and that staff followed. People were happy with the leadership and approachability of the service’s provider and the management team. Staff felt well supported by provider. Audits were effective and risks were monitored by the provider to keep people safe.

During this inspection we set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty with the appropriate skills and experience to meet the needs of the people living at the home. Staff provided care and support during the day and night. People used call bells to request assistance from staff.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us "The staff help me with my tablets'. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were patient and gave encouragement when supporting people. People told us they were able to make their own choices in their everyday lives. Our observations confirmed this. One person told us 'The staff are wonderful and very friendly".

Is the service responsive?

People's needs had been assessed before they moved into the home. There was evidence that staff regularly discussed any changes related to people's care with them. Records confirmed people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided that met their wishes. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives. We observed that when one person pressed a call bell, staff responded immediately.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. People told us they were asked for their feedback on the service they received and that they had also filled in a quality survey. They confirmed they had been listened to. Staff told us they were clear about their roles and responsibilities. They said the management had consulted with them before implementing changes to the work hours of the home and their views had been taken into consideration.

People told us that they were supported to make their own day-to-day decisions and were involved in how their care and support was provided.

We looked at people's care plans. We found that they had been reviewed recently, they contained some easy to read information and some evidence of the involvement of the people they were designed to support.

We looked around the service with the manager, we found that it was clean, well maintained and provided a safe and comfortable environment in which to live. One person told us 'The house is always kept nicely'.

We found that arrangements were in place to monitor the quality and safety of the service provided.

When we arrived at the home, all five of the people who live there were out attending activities in the community. We saw that all the people in the home had an activity plan, which included regular routines and activities inside and outside the home.

We saw that people received care from their GP and hospital specialists as necessary, and attended routine healthcare appointments with their dentist and optician.

The people we spoke with told us they felt safe in the home, and would go to the manager or other staff if they had any concerns. People told us they attended house meetings, where they discussed what they wanted to do and had a say in the running of the house. The home provided forms for visitors to provide feedback on the service, and we saw that this was mostly positive.

Records were kept of staff recruitment, employment and training, which showed that when people were recruited the necessary employment checks were completed.