Archived: Ryedale Special Families

At the last inspection on 5 September 2014 the service was meeting the regulation that was assessed.

Ryedale Special Families is an organisation registered as a domiciliary care agency to provide personal care. The organisation provides support for children and young people in their own homes and out in the community.

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.

We found staff were robustly recruited, trained in topics relevant to the service and were in sufficient numbers to meet children and young people’s needs. Staff were recruited and trained according to the individual child’s care package and the range of activities being offered.

Young people were encouraged to help with recruitment and were actively involved in the development of the service. Staff were matched to work with children and young people wherever possible and the service regularly asked parents for feedback to ensure the arrangement was working well. The matching process ensured that staff got to know the child well, were properly trained and had the appropriate skills to meet their needs.

Only those staff who were trained to administer medicines supported children who might require such assistance. In these cases there were protocols around the use of medicines and when they could be administered.

Staff were aware of the Mental Capacity Act (2005), which would be applicable for some of the older children. However, staff were not responsible for the general welfare of the children or the younger people who lived with their parents or guardians. Staff had been trained in child protection and safeguarding topics and the parents we spoke with said staff followed safe practice and could be trusted.

The care service operated out of an adapted residential building and there were rooms for children’s play, and a television room that could also be used for private conversations. Plans of care were individual to each child and these were reviewed to ensure staff were up to date with any changes. Staff completed a record either in the child’s own home or on return from any activities and these were forwarded to the children’s specialist team to ensure everyone knew what the children had done.

Children were provided with lots of different activities, youth clubs and outings. The outings were developed over time and were dependent upon how much the child enjoyed and participated in them. Parents told us they felt able to raise any concerns but did not have any. They said the registered manager and the staff team were very approachable.

Effective management systems were in place for the registered manager to analyse incidents, accidents and compliments to improve the service or minimise risks. There had not been any concerns or incidents since the last inspection. Policies and procedures were updated and the registered manager used audits to help them with their checks on the quality of the service.

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary is based on our observations during the inspection and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We found that the provider had addressed the issues within the previous report through retraining staff, review and rewriting of the policies in place, and updated systems for monitoring staff performance and understanding in the area.

Is the service effective?

Effective monitoring systems were now in place to make sure that safeguarding was fully understood and the correct procedures were followed.

Is the service caring?

Not applicable. We did not inspect this area.

Is the service responsive?

Not applicable. We did not inspect this area.

Is the service well-led?

Not applicable. We did not inspect this area.

As part of this inspection we looked at records for eight people who used the service. We spoke with the manager and team leaders during the inspection. We also spoke with relatives of children who were supported by the service. We reviewed records relating to the management of the service.

Below is a summary of what we found. The summary describes what relatives of people who used the service and staff told us, and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

As part of this inspection we looked at the ways in which the service understood and managed safeguarding. This included talking to staff about their understanding and to management staff about the processes that should be followed when there are any safeguarding issues.

We found that there was some level of understanding relating to types of abuse but that knowledge of the appropriate procedures to follow for reporting and investigating possible abuse were not well understood.

Relatives of people who used the service felt that the staff had a good understanding of how to minimise risk and respond to incidents. Records also showed that this was the case. Risk assessments were in place and had been appropriately written and reviewed. Operational staff recording of incidents was good.

Staff training for safeguarding was overdue and policies were not very robust around the management and reporting of safeguarding. Incidents had occurred that required reporting but these had not been escalated appropriately or in a timely manner. We have asked the provider to take some action to address these issues.

Is the service effective?

Children each had an individual care plan. Care plans contained useful information and families had been involved in the development of these. When we spoke with relatives they told us that they had been fully involved in the development and reviews of these, as had their children where appropriate or when possible. The plans were detailed and personalised and gave clear guidance for staff about how to support each individual.

The care plans and risk assessments were detailed and identified ways to minimise risks. We saw that plans and risk assessments were regularly reviewed and were up to date.

When we spoke with relatives of people who used the service they were very pleased with the support they received from staff. One person told us 'The support we have had as a family as well as my child individually has been fantastic. The support is consistent and staff have provided an incredible level of care'. Another told us 'The staff are absolutely brilliant and it has had such an impact on my relatives life'.

There were a range of systems in place for monitoring and auditing the effectiveness of the care and support given, particularly the development of new types of support to meet the changing needs of people who were using the service. This was being done creatively and with the full involvement of young adults and children who were already involved with the service. This meant that the provision was altering according to the needs of people using it.

Is the service caring?

When we spoke with relatives of people who used the service they were very complimentary about the quality of support that was provided by staff. One person told us 'The service has adapted in order to make what my relative accesses appropriate for his age and interests. The communication is good and the staff have worked out great ways to work with my relative'. Another person told us 'The staff have supported all of the family through a very difficult time and the support has been amazing. They showed they cared about all of us, not just the child that was receiving support and I don't know how I could have got through it without their support and care'. A third relative told us 'The staff genuinely care about my child and my whole family ' it really is the whole package'.

Is the service responsive?

As part of our inspection we looked at the feedback that had been gathered from staff, children and their families. We also looked at the ways the service responded to incidents and accidents. We spoke with relatives of people who used the service about this element of the support that was being provided.

We found that there were systems in place to gather feedback and information regarding the quality of the service and development of new things to ensure that the service continued to meet the needs of those using it. This meant that the service was responding to people's changing needs as well as more global issues such as funding, arrangement and monitoring of services by social services, and needs analysis of the local community.

Is the service well-led?

There was a manager in place who had worked at the service for a long period of time. There were also team leaders in post. When we spoke with relatives of people who used the service and staff they were positive about the roles that were in place and the way the service was managed.

During the inspection we were able to see evidence that showed that the service was being managed appropriately and as a result was meeting the needs of people who used the service effectively. Relatives we spoke with said that the management within the service were very approachable and responded quickly when any issues were raised.

We spoke with people about the quality of the service they were receiving. One person told us 'I don't know what I would do without them. They are wonderful'. Another person told us 'They support us whenever we need it in whatever way they can'.

We found that staffing levels were appropriate and there were good systems in place for matching staff with families. The organisation had a robust system in place for collecting feedback and acted on this appropriately. The complaints process was followed well and families were made aware of how they could raise any issues.

We found that records were accurate and regularly updated and were stored appropriately. There were several pieces of paperwork identified that needed some reviewing and the organisation committed to considering these updates over the next year.