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Inspection carried out on 5 February 2019

During a routine inspection

About the service:

Wigan Link is a domiciliary care service, providing personal care to people living in their own home including a number of supported living settings. 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. At the time of inspection there were approximately 30 people receiving a regulated activity. At the last inspection we rated the service as Outstanding, however, we have not been able to rate the service as Outstanding this time because there is no registered manager in post and an application to register a new registered manager has not been made.

People's experience of using the service:

The registered provider continued to provide exceptionally person centred care and support which people told us had significantly improved their quality of life. This included supporting people to develop their confidence and skills in ways which meant they were more empowered and in control of their lives and went beyond the expectations of their families and other professionals.

Exceptionally detailed assessments of people's needs had allowed for their care and support to be highly effective. Staff were knowledgeable about the needs and wishes of the person they supported. Staff were highly skilled and competent. Input from families and a broad range of involved professionals further contributed to the effectiveness of the care and support provided.

People were involved in choosing their staff and were consulted about who supported them. The service carefully matched staff to people receiving care and support.

Risk management policies were robust and supported people to manage the risks in their daily lives. Best practice guidance in relation to positive risk taking was an embedded practice and promoted the rights of an individual to make their own decisions with the support they needed. This had increased people's decision making opportunities and expectations.

The service promoted optimum health and wellbeing, some people had achieved very positive outcomes, including; significant weight loss, improved mobility and reduction in the frequency and severity of incidents of distress.

The service was exceptionally caring. Respect for people was a key value and was reflected throughout the service. Without exception, everyone we spoke with praised the caring and kind nature of their staff and the management team. People's communication needs had been identified and strategies developed to support people to be as involved as possible in decisions about their care and support. This had led to exceptional outcomes for some people who had been supported to communicate their feelings and had developed ways of responding which reduced some of the risks of harm.

Wigan Link had a fully embedded person-centred culture which contributed to the very high-quality care and support provided. People's expectations, and their families, were consistently exceeded.

People received exceptionally person-centred care which reflected their needs and preferences. Carefully matched staff contributed to the responsiveness of the support provided. Regular reviews of people's needs and preferences helped maintain focus on what was most important to the person. A diverse range of activities were designed around people's wishes and preferences, staff went to exceptional lengths to improve the quality of people's lives by supporting them to achieve their goals.

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. The service continued to embed these key principles within the service to empower people to live the life they

Inspection carried out on 07 & 08 September 2015

During a routine inspection

This was an announced inspection carried out on the 07 and 08 September 2015. The inspection was announced so that the manager would be available at the office to facilitate our inspection.

The service was last inspected on 13 August 2013 and at the time was meeting all regulations assessed during the inspection.

Wigan Link, is a local registered charity that provides support services for adults whose primary need for care is due to their learning disability. Support is provided for people, with varying complex needs, who choose to live alone or who share a home with others. Wigan Link provides support to people living in Wigan and Leigh. At the time of this inspection there were 28 people who used the service.

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.

Wigan Link provides a range of support, from people receiving a few support hours several times a week, to 24 hour support for people in their own home. People live in shared ownership housing, private rented or local authority housing. This means they have tenancy agreements with a landlord and a separate agreement to receive their care and support from Wigan Link. As the housing and care arrangements are entirely separate, people can choose to change their care provider without losing their home.

The registered manager was one of the founders of Wigan Link 15 years ago and it has remained a family led service. Wigan Link demonstrated a strong emphasis on empowering people to voice their opinions and views. The management committee of Wigan Link was made up of people receiving support, parents with sons/daughters described as people with “learning disabilities”, working with other parents, and advisors from the Local and Health Authorities.

People receiving support, relatives and care staff consistently told us that the service was well run and provided positive leadership. There was a strong emphasis on people pursuing full, active lives in their own communities. The registered manager was involved in the local drama group and empowered people receiving support to be involved and engage in activities of their choosing in the community. People receiving support, relatives and staff had a positive and affectionate regard for the registered manager and the management team at Wigan Link.

We looked at how the service managed risk. The registered manager told us the service had developed a person centred approach to risk that was assessed in conjunction with the people who used the service, their families and staff. It was based on listening to what was important to people. We found individual risks had been completed for each person and recorded in their guidelines. The guidelines were reviewed and updated when there was a change in risk.

We looked at 10 personnel files and found people were protected against the risks of abuse because the service had robust recruitment procedures in place. We found appropriate criminal records bureau (CRB) disclosures or Disclosure and Barring Service (DBS) checks had been undertaken and appropriate references obtained before new staff commenced employment with the service.

We looked at how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe. We looked at the staff rotas. We found the service had sufficient skilled staff to meet people's needs. People receiving support and staff told us any shortfalls, due to sickness or leave, were covered by existing staff which enabled continuity of service and ensured people were looked after by staff who knew them.

People receiving support were involved in recruitment and we found that all new members of staff underwent a comprehensive induction programme, which was designed to welcome them to the service and support them during the probationary period. We reviewed training records, which were up to date and included refresher training courses to enable staff to develop their skills and knowledge. Care staff confirmed they received regular supervision and appraisals, which we verified by looking at staff personnel records.

We considered the Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS) and obtaining consent from people. We saw that the service had been involved with the Local Authority undertaking mental capacity assessments. There was nobody in service subject to DoLs and although staff had not attended training around the Mental Capacity Act they demonstrated a good understanding of obtaining consent and best interest decisions.

The feedback we received from people was positive. Those people who used the service expressed great satisfaction and spoke highly of the registered manager and staff.

We asked people and their relatives how they felt about the caring approach of the staff. Without exception, people and relatives praised the staff for their caring and professional approach. One relative said, “We call them the A team, I can’t fault them. They’re always on time. Very regular. All work as a team. They take care for the person and they are also friends.”

People were at the heart of the service, which was organised to suit their individual needs and aspirations. People’s achievements were celebrated and their views were sought and acted on. People were supported by staff that were compassionate and treated them with dignity and respect. We spoke with five people receiving support from Wigan Link and nine relatives. Without exception, people who used the service and their relatives were complimentary and positive about the staff that supported them.

People were active members of their local community and led busy and fulfilling lives. There was evidence of positive outcomes for people, and that people had pursued new opportunities, progressed over time, gained new skills and increased their independence. People were enabled through positive risk taking, to challenge themselves to achieve and fulfil their ambitions. One relative told us, “The essential lifestyle plan captured our hopes, dreams and fears. How we wanted support to be. This is updated and tested regularly.”

People told us that the service had made a real difference to people’s lives. Three people we spoke with told us their relatives were living better lives than previously; they were doing more and becoming more independent. Three people told us their relative had previously lived at home leading a protected life and not going out much. They had nothing but praise for the service in enhancing their relative’s lives.

People told us the service engaged consistently and meaningfully with families. The nine relatives that we spoke with reported feeling involved and being part of an extended family. They reported the service to be responsive, open and transparent and feeling actively involved in all aspects of care. A member of staff told us, “Everything is flexible and responsive; it’s down to us having a good knowledge, information and understanding of the person.”

Inspection carried out on 13 August 2013

During a routine inspection

On the day of the inspection we found that the provider was in the process of moving offices to a new location nearby. However we were still able to speak with people who used the service, members of staff and relatives.

People were positive about the support provided and told us comments such as '' We are very fortunate to have the continuation of three support workers who have been with us quite a while.'' ''We are very happy, they are the only provider that we know of who provide good care and continuity'' and '' Everything is organised in the way that I want it to be''.

Inspection carried out on 27 September 2012

During a routine inspection

We spoke with three relatives and one person who used the service. They were all positive about their experience and the documented evidence reflected this. A compliment letter that had been sent to the provider recorded that they now had a dedicated team of four staff for their relative. They stated that '' I don't know how Wigan Link match people up but they are excellent at this. The team are fantastic.''

One person using the service that we spoke with said that they were very happy with the support that they had and were offered lots of choices.

The care staff that we spoke with had a good knowledge of how to meet the needs of the people they were supporting and were able to tell us of how they respected peoples privacy and dignity.

All of the staff spoken with said that they thought a good level of support was provided to the service users.