Archived: Pioneering Independence

Pioneering Independence provides a support service to people living in their own home. On the day of the inspection one person was supported by Pioneering Independence with their personal care needs.

The service had 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.

Staff put people at the heart of their work; they spoke with affection about people and described their dedication to providing high quality care and support to the people they supported. Strong relationships had been developed and staff spoke with pride about the things they had supported people to achieve. Staff were highly motivated, creative in finding ways to overcome obstacles that restricted people’s independence and had an in-depth appreciation of how to respect people’s individual needs around their privacy and dignity.

Care records were personalised and gave people control over all aspects of their lives. Staff responded quickly to people’s change in needs. People and where appropriate those who mattered to them, were involved in regularly reviewing their needs and how they would like to be supported. People’s preferences were identified and respected.

People’s risks were managed well and monitored. People were promoted to live full and active lives and were supported to be as independent as possible. Activities were meaningful and reflected people’s interests and individual hobbies.

People had their medicines managed safely. People received their medicines as prescribed and received them on time.

People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers and speech and language therapists.

All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults before they started their employment.

People were supported to maintain relationships with those who mattered to them. People and those who mattered to them knew how to raise concerns and make complaints although no written complaints had been made to the service.

Staff described the management as supportive and approachable. Staff talked positively about their jobs. Staff received a comprehensive induction programme. There were sufficient staff to meet people’s needs. Staff were appropriately trained and had the correct skills to carry out their roles effectively.

Staff understood their role with regards the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. Applications were made and advice was sought to help safeguard people and protect their human rights.

There were effective quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents and concerns raised was used to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.

Below is a summary of what we found. The summary describes what the person using the service, their relative and members of their staff team told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

The person was cared for in their own rented bungalow. They received a twenty-four hour two to one support service. They were the only person who lived in the bungalow. At night one of their support staff stayed awake all night while the other member of staff slept in a room in the bungalow. The bungalow had been adapted, so far as it was possible, to meet the person's particular needs.

Management and staff accessed specialist external advice and training to ensure that the person's support was safe and appropriate to meet their needs.

Is the service effective?

The person, and their relative, told us that they were happy with the care and support they received. They felt their needs had been met. It was clear from what we saw, and from speaking with staff, that they understood the person's care and support needs and that they knew them well. Staff were able to describe how they delivered particular care requirements.

The person's relative told us that they thought their relative "Is happy now."

Is the service caring?

We met four of the team of eight staff who supported the person. They appeared to be caring and supportive. We saw that the staff were patient and gave encouragement when supporting the person. The staff told us that they knew what sort of things the person liked to do and they went out of their way to facilitate this. In addition we heard how the team was seeking to widen the experiences and options that the person would consider.

The person's relative told us "They seem to be a caring team."

Is the service responsive?

The person's needs had been assessed before they moved into the service. The files showed that the person's preferences and interests were known and that staff sort to facilitate these. For example we were told that the person liked ice cream and we saw photographs of them eating ice cream in various locations.

We saw that Emtill Projects tried to match the correct staff to the person. The person's relative told us that when they first moved into the bungalow there was quite a high turnover of staff but that now there appeared to be a stable team.

Is the service well-led?

We were given a copy of the organisational structure. From that we could see that Emtill Projects employed professional staff to provide support and advice to the care staff. Staff at the service commented on the quality of the support they received from "the office". Staff told us that they could always telephone for advice and that following any incidents they were offered additional "ad hoc" supervision. The person's relative confirmed the quality of the management commenting that the senior practice manager was "very good." They went on to say that the house manager and the service kept in contact with the family.

People and their representatives were involved in an assessment of their individual needs. We saw documents relating to people's care that were up to date and reviewed regularly. However the agency had not devised a detailed plan of care for the person. We spoke to two staff who were knowledgeable about most aspects of the person's care but there were some areas they were not sure about. This meant that the person may be at risk of receiving care that was inappropriate or unsafe.

We spoke with two care workers and three members of the management team including the Nominated Individual who is the person registered with us as responsible for the conduct of the organisation. Suitable arrangements were in place to ensure people who used the service were safeguarded against the risk of abuse. Staff recruitment procedures had improved to ensure that the care workers employed for the purpose of carrying out personal care were of good character.

The agency had good systems in place to monitor the quality of the care/support they provided. This included obtaining feedback from people who used the service and relatives.

We spoke with one care worker and three members of the management team including the Nominated Individual who is the person registered with us as responsible for the conduct of the organisation. Care workers had received training for their role and met regularly with their line manager which enabled them to do their work effectively.

We found that the agency had good systems in place to obtain feedback from people who used the service and relatives and to monitor the quality of the care/support that they provided. However we found that recruitment practices were not effective enough to ensure that people were employed who were of good character.