Jump 2 Independence Limited

Jump 2 independence is a domiciliary care agency and supported living service providing personal care to people living in their own homes. At the time of the inspection 44 people were receiving personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

People were safeguarded from abuse and avoidable harm. The provider ensured there were sufficient numbers of suitable staff. People were supported to receive their medicines safely. The provider learned lessons when things had gone wrong. The provider had systems to provide person-centred care that achieved good outcomes for people.

Right Care

The provider assessed risks to ensure people were safe. Staff took action to mitigate any identified risks. People and staff were involved in the running of the service and fully understood and took into account people’s protected characteristics. People were protected from the risk of infection as staff were following safe infection prevention and control practices.

Right Culture

There was a positive and open culture at the service. The provider understood their responsibilities under the duty of candour. The provider had a clear management structure that monitored the quality of care to drive improvements in service delivery. The provider had created a learning culture at the service which improved the care people received. The provider worked in partnership with others.

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.

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 (published 29 March 2019).

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm. Please see the safe and well led sections of this full report.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Jump 2 Independence on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

•People were protected from the risk of harm and abuse by suitably skilled staff who had received relevant and appropriate training to recognise and report signs of abuse and risk. There were sufficient numbers of staff to meet people’s needs.

•Staff felt supported in their role by an approachable management team who worked well with each other to provide consistent care and support for people. The staff team worked well with other professionals and organisations to ensure people received effective care and support as needed.

•People were encouraged to maintain their independence and staff understood how to protect and preserve people’s rights. People were treated kindly by a friendly and caring team of staff.

•Staff knew people well and were able to respond to people’s individual needs and preferences.

•The service had systems in place to respond to complaints or compliments that were received from people or relatives.

•The registered managers had systems in place to drive improvement in the service.

The service met the characteristics of Good in all areas. More information is contained within the full report.

Rating at last inspection: The service was rated as Requires Improvement (report published 21 December 2017).

Why we inspected: This was a planned inspection based on the date and the previous rating of the service.

Follow up: We will continue to monitor the service through information we receive.

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

We undertook this inspection to check that they had followed their plan and to confirm that they now met the legal requirement. We found that improvements had been made so the regulation was no longer being breached.

The office inspection took place on 11 October 2017, with a visit to people in receipt of a supported living service on 12 October 2017. Follow up phone calls to people, relatives and staff took place after this up to 26 October 2017. We gave the provider 48 hours’ notice. This was to ensure that someone would be available in the office as it is a domiciliary care service. At the time of our inspection there were approximately 46 people using the service with a range of support needs such as people living with dementia, learning disabilities, a physical disability and older people.

There were two Registered Managers in post at the time of our inspection. 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’s medicines were not always recorded. Instructions were not always available for staff to follow and there were not always explanations when medicines had not been recorded as administered.

Staff were not always deployed effectively to cover all calls, however people were overall very happy with the punctuality of the staff.

Some guidance for staff was not always present, for instance in relation to supporting a person with becoming agitated or some health needs like diabetes or continence care.

Audits were not always effective at identifying when information was missing. New audit systems were being introduced and a new role had been created to focus on quality assurance however this was not yet embedded.

People were asked for their opinion about their care but timely action had not always been taken to incorporate this into the service improvement plan.

People told us they felt safe. People also told us they were supported to move safely around their home and there were risk assessments in place.

Staff wore gloves and aprons to ensure infection control guidelines were met.

Safe recruitment practices were followed to ensure appropriate staff were working with people who used the service.

The principles of the Mental Capacity Act (MCA) 2005 were being followed and staff were checking consent prior to supporting people.

People felt staff were well trained and were knowledgeable about their role. Staff confirmed they received training.

People were supported to maintain their nutritional needs appropriately.

People had access to other health professionals and the service worked with them to support people to maintain their health and wellbeing.

People and relatives told us staff were kind and caring. Staff ensured people maintained their dignity and were supported to remain as independent as possible and make decisions about their care.

People and relatives told us they felt involved in their care and care plans contained personal detail and preferences about how people liked to be supported.

People know how to and felt about to make a complaint. Complaints were acted upon and responded to appropriately.

People, relative, staff and other health professionals had confidence in the staff team and in the registered managers. Staff also had their competency checked.

The service provides personal care to people who live in their own homes and also provides supported living services. At the time of the inspection there were approximately 50 people using the service to receive the regulated activity of personal care.

There were two registered managers 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.

The service did not always act in accordance with the Mental Capacity Act 2005 when people were unable to consent to their own care and treatment. This meant that people's legal and human rights may not always be upheld. This was a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Care plans did not always contain accurate and up to date information to ensure that staff had information they needed to provide personalised care that met people’s needs. However, staff knew people well and care plans did contain life history information and details of people’s preferences.

Quality assurance systems were not always effective to ensure that issues with quality were identified and acted upon in order to drive continuous improvement.

People felt safe and staff understood their responsibilities to keep people safe where abuse may be suspected.

People's risks were assessed and monitored in order to keep them safe and support their wellbeing. There were enough suitably qualified staff available to meet people's assessed needs and safe recruitment practices had been followed.

We found that people received support with their medicines when required and the registered manager was going to introduce protocols to ensure that staff knew when to give ‘as and when required’ creams and medicines.

Staff received training and supervision which ensured they had the knowledge and skills required to meet people's needs.

People were supported to eat and drink sufficient amounts and staff encouraged people to make choices about their eating and drinking.

People were supported to access health professionals and referrals for advice were sought by staff, which ensured people's health and wellbeing was maintained.

People received care that was caring and compassionate and they were enabled to make choices about their care. People's privacy and dignity was maintained when they received support from staff.

People told us they knew how to complain and the provider had an effective system in place to investigate and respond to complaints.

People’s relatives and staff had confidence in the registered managers and felt they were approachable.

The service worked in partnership with key agencies to help ensure that people received holistic support.