Allen Meale Way

Allen Meale Way is registered to provide personal care to people in their own homes. At the time of the inspection they provided a supported living service to nine people living with learning and physical disabilities. Supported living is where people live in their own home and receive care and support to promote their independence. The service is provided over three locations, two of which were on the same site as the registered office.

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.

People’s experience of using this service and what we found

The proactive and empowering culture within the service meant people achieved their potential with dedicated support from staff. Care was person-centred, individualised and inclusive and regularly reviewed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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.

There were enough safely recruited staff to meet people’s needs in a timely and appropriate manner. The risks people may be exposed to had been identified and mitigated. Staff had a good knowledge of safeguarding practices helping to protect people from the risk of abuse and avoidable harm. People received their medicines safely and in line with good practice. Their health and nutritional needs were met.

People benefitted from receiving care and support from staff who were experienced and skilled. Staff had received specific training to meet the often-complex needs of the people who used the service and support was ongoing and effective. Their competency and performance were regularly monitored to ensure the quality of the service was consistent and of a good quality.

Staff supported people in a warm and engaging manner and used appropriate humour to strengthen rapport. They were comforting, kind and considerate. People were treated with respect and their dignity was maintained and consistently considered by staff who understood the importance of this. People were encouraged to be as independent as possible. Staff were skilled in communicating and understanding the needs of the people who used the service.

There was a stable management team in place who understood their regulatory and legislative responsibilities. They strived for improvement within the service and were open and receptive, working well with others. They felt supported and kept their knowledge up to date. People described the management team as approachable and knowledgeable. Staff respected their colleagues, worked well as a team and were effective.

An effective quality monitoring system had ensured people received good care and identified areas for continued improvement. The registered and deputy managers had a good oversight of the service and were committed to ongoing development of the service. This included being open when things went wrong and valuing people’s views and suggestions.

Relatives we spoke with were very happy with the service their family members received and health professionals spoke positively about the care and support delivered. One relative told us, “The care [family member] receives is brilliant.” Another said, “Everyone here are old friends. I’ve got no worries at all.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (report published on 7 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

The service is registered to provide personal care to people in their own homes. It provides a supported living service to 14 people who live in shared houses on three separate sites. The service provides care and support to people with learning disabilities.

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.

People and relatives felt people receiving the service were safe. Risks to people were identified and responded to. Incidents and accidents were reported, analysed, and responded to. Staff demonstrated an awareness of adult safeguarding and knew how to report concerns

There was sufficient staff to keep people safe and meet their needs. People were supported by a stable and consistent staff group. Staff had been recruited following safe recruitment practices. Staff had the knowledge and support to meet people’s needs effectively. They received regular training and staff felt supported by their colleagues and the registered manager to provide effective care.

Most areas of medicine administration were managed safely. There was guidance in place so staff knew how to administer medicines. Regular audits were taken on medicines to check and ensure they were managed safely.

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. People can only be deprived of their liberty to receive care and treatment when this is in their best interest and legally authorised under the MCA. Staff and the management team understood the MCA and how this impacted on the support they provided.

People were supported with their dietary needs and encouraged to eat healthily. Staff ensured people were supported to access health care professionals and manage on-going health conditions.

People were supported by staff who cared for them and treated them respectfully. Staff supported people to discuss their views on the support provided. Some people using the service had complex communication needs. Staff understood people’s individual gestures and how they communicated so people were able to express themselves. Relatives felt involved and consulted, where appropriate. People were supported to be as independent as possible; staff were proud of the achievements people had made.

Staff ensured they knew people’s individual preferences and needs. Support was provided in a way that met these. Where staff were responsible for supporting people to access activities, these were provided in a way that met people’s individual interests and likes.

People and relatives felt able to raise concerns. They felt confident that action would be taken to resolve any concerns they raised.

People, relatives, and staff were positive about the support and leadership of the registered manager. Staff told us they felt supported, listened to, and involved in the running of the service. There were quality monitoring processes in place to help monitor and identity issues that might affect the quality of the service provided.

We looked at written records, which included people's care records, staff personnel files, medication systems and quality assurance documentation. We spoke with one person who used the service. We could not speak with other people due to their communication needs. We also spoke with the manager, the assistant manager and three members of care staff.

We considered our inspection findings to answer the five questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? This is a summary of what we found based on our observations during the inspection.

If you want to see the evidence supporting our summary, please read the full report.

Is the service caring?

We spoke with one person who used the service. In response to our question, "Do you like living here," they replied, "Yes." In response to our question, "Are the staff kind to you," they also responded, "Yes." We we not able to speak with other people due to their communication needs. We observed the care and attention people received from staff. All interactions we saw were respectful and friendly and there was a relaxed atmosphere throughout the service.

Is the service responsive?

Care plans and risk assessments were informative, up to date and regularly reviewed. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care records.

Staff told us that the manager and other senior staff were approachable and they would have no difficulty speaking to them if they had any concerns about the service. We found that the provider listened to and acted upon views from people who used the service and their families.

Is the service safe?

The accommodation was adapted to meet the needs of the people living there. It was suited to caring for people with limited mobility and was properly maintained. The service was warm and clean.

People were protected by effective staff recruitment systems. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

People were cared for by staff who were properly trained and supported to develop professionally. Feedback received from people's families as part of the provider's own annual quality assurance survey was positive.

Is the service well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

Most of the people living in Allen Meale Way were unable to communicate or give their consent verbally. Staff described how they interpreted how people were feeling in order to gauge their consent. Where significant decisions needed to be made and people did not have the capacity to give their consent, the provider acted in accordance with legal requirements.

We looked at the systems in place for the management of medicines. We found that the arrangements for the storage and recording of unused medications were inadequate and discussed this with the home's managers. The audit that should have identified these issues did not do so.

We reviewed records relating to staff recruitment and found that effective recruitment and selection processes were in place. Appropriate checks were made to ensure staff were suitable to carry out their roles.

The provider had systems in place to assess and monitor the quality of service provision.

We saw that staff spoke to people in a calm and supportive way, offering choices and respecting them wherever they could. People received care and support in line with their support plan and we could see that the plans were kept under review and up to date. People were relaxed and happy, engaged in meaningful occupation that they enjoyed. Staff were knowledgeable about keeping people safe and the signs they should look out for in case someone was being abused. There were also processes in place to protect people from financial abuse.

We saw that there were enough staff on duty to support people effectively. Staff were skilled and experienced, with most having worked at the service for more than five years. They had received training that was relevant to their role.

There was a complaints procedure in place, a copy of which was provided to each person. The procedure was also written in pictorial form to help people understand the process. Staff were available to help people express concerns and to support them to make a complaint if they wished.