Archived: Northallerton

The Royal Society of Mencap Northallerton is a domiciliary care service that provides personal care and support to people with learning disabilities and autism, who live in their own homes or supported living. The service covers the Darlington, Gateshead and County Durham area and at the time of our inspection the service supported 31 people.

At the time of our inspection the service didn’t have registered manager. 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 the time of our inspection there was a manager in place managing the service who wasn’t registered with CQC. The manager had contacted CQC regarding registration, but was still in the first stage and hadn’t yet submitted an application.

We spoke with support workers who told us that the manager was always available and approachable. We spoke with people who used the service on the day of the inspection and their relatives who also told us the manager was accessible and open.

We saw that people’s prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the manager about how staff were trained to administer medicines. We found that the medicine administration, recording and auditing process was safe.

From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans made good use of personal history and described individual’s care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the support workers and the registered manager.

People who used the service received person centred support and their individual needs were respected and valued.

Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. For example, their doctor and care manager.

Our conversations with people who used the service and their relatives showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.

We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service chose their own staff and together with their families were a major part of the recruitment process.

People were encouraged to plan and participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including accessing local facilities and the wider community.

We saw a compliments and complaints procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed them.

We found the service had been regularly reviewed through a range of internal and external audits. We saw action had been taken to improve the service or put right any issues found. We found people who used the service, their representatives and healthcare professionals were regularly asked for their views about the service via surveys and ‘service reflection events,’ where people came together to discuss their views and have their say about the service.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. Any applications must be made to the Court of Protection. At the time of this inspection applications had been made to the Court of Protection and several others had gone through the process.

People who used the service generally lived together in shared houses and were provided with twenty-four hour support. We visited two houses and met with six people and spoke with one relative via the telephone.

People experienced care, treatment and support that met their needs and protected their rights. People told us they were very satisfied with the care support they received and comments from people included: 'We are highly delighted with the support X receives, we can tell by the look on x's face that they are very happy with the way they are looked after.' And 'I really like the staff they help me with shopping and going out and about.'

The agency had clear systems in place for supporting people with medication and staff were trained in the safe handling of medicines.

The agency had a robust recruitment process in place. This meant that only suitable people who had completed appropriate employment checks worked for the agency. All of the staff we spoke with told us the induction they received had been a good grounding and relevant to their role.

The agency had an effective system in place to regularly assess and monitor the quality of service that people received. These ranged from annual surveys completed by staff and people who used the service, to daily and weekly checks in people's houses to maintain a good standard of support.

Records were well maintained, up to date and kept securely.

We spoke with four members of staff who told us that the agency was very supportive, particularly emergency out of office support and provided good opportunities for training.