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Access Community Services Limited Good

Inspection Summary


Overall summary & rating

Good

Updated 10 October 2018

Access Community Services Limited is based in Southport, Merseyside and provides personal care and support to people who have learning disabilities, physical disabilities or mental health conditions. The service provides care and support to people living in their own homes including ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This was an Announced inspection which took place over two days on 20 and 21 August 2018. The service was supporting 45 people within supported living and 52 people in the community; 36 of the total 97 individuals received support with personal care.

We last carried out an inspection of this service in November 2017. This had been a ‘focussed’ inspection where we looked specifically at previous breaches of regulations. We found there had been overall improvements but the service still required to improve some management systems as the provider’s action plan had not been fully met and there were areas that still required development and implementation. The service was rated as ‘Requires improvement’ for the second consecutive inspection.

On this inspection we found continued improvement and more consistent and sustained service delivery. Managers had continued to develop management systems to assess and monitor the service ongoing and the remaining breach of regulations regarding the governance of the service had been met. The registered manager could evidence a series of quality assurance processes. There was a clear management hierarchy and we saw that new ideas and service improvements were effectively developed and communicated.

We rated the service as Good.

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.

We visited two of the supported living houses which were staffed by the care agency. We also spoke with people who were receiving support at their own homes. The observations made and feedback we received evidenced people were getting good support. External professionals involved in peoples care also gave positive feedback which gave further evidence of a good service.

We found medicines were administered safely. Medication administration records [MARs] were completed in line with the service's policies and good practice guidance. We pointed out some anomalies in one ‘house’ we visited concerning safe storage of medications and staff knowledge regarding covert administration of medicines [medicines given without a person’s consent] and both issues where addressed by managers.

There were arrangements in place for checking the care environment to help ensure this was safe. These arrangements included regular checks and audits by house managers which were supported by health and safety audits by senior managers.

People using the service, relatives, professionals and staff told us they felt the culture of the organisation was fair and open and supported good care and support for people using the service.

People we spoke with said they felt safe with the staff from the agency and the support they received. We were told that if any issues arose they were addressed by the managers.

We saw

Inspection areas

Safe

Good

Updated 10 October 2018

The service was safe.

Medicines were administered safely. Medication administration records [MARs] were completed in line with the service's policies and good practice guidance.

There was a good level of understanding regarding how safe care was managed. Care was organised so any risks were assessed and plans put in place to maximise people�s independence whilst helping ensure they are safe.

Staff understood what abuse meant and knew the correct procedure to follow if they thought someone was being abused.

There were enough staff employed to help ensure people were cared for flexibly and in a safe manner. Staff had been checked when they were recruited to ensure they were suitable to work with vulnerable adults.

Effective

Good

Updated 10 October 2018

The service was effective.

The service worked in accordance with the Mental Capacity Act 2005. Care planning contained enough detail regarding people�s decisions around key issues.

Systems were in place to provide staff support. This included on-going training, staff supervision, appraisals and staff meetings.

People�s care documents showed details about people�s medical conditions and appointments with health care professionals such as GPs and district nurse teams to help support people in their own home.

Staff said they were supported through induction, supervision, appraisal and the service�s training programme.

Caring

Good

Updated 10 October 2018

The service was caring.

The feedback we received evidenced a caring service. People being supported and their relatives commented positively on how the staff approached care.

Staff treated people with respect and dignity. They had a good understanding of people�s needs and preferences.

People we spoke with and relatives told us the manager�s and staff communicated with them effectively about changes to care and involved them in any plans and decisions.

Responsive

Good

Updated 10 October 2018

The service was responsive.

People�s care was planned so it was personalised and reflected their current and on-going care needs.

A process for managing complaints was in place and people we spoke with and relatives were confident they could approach staff and make a complaint if they needed.

People in receipt of end of life care were assessed and appropriate measures were in place to provide support.

Well-led

Good

Updated 10 October 2018

The service was well led.

The registered manager provided an effective lead in the service and was supported by a clinical manager and other service managers in a clear management structure.

We found an open and person-centred culture. This was evidenced throughout for all the interviews conducted through to care and records reviewed.

There were systems in place to gather feedback from people so that the service was developed with respect to their needs.