21 & 22 September 2015
During a routine inspection
The inspection took place on 21 and 22 September 2015. The inspection was unannounced.
The service is domiciliary care agency that is based on the same principles of a supported living scheme. The service provided care and support for up to seven people with learning disability needs. On the day of our inspection there were six people using the service. Three females resided together in one house and up to four males resided together in the house next door. Each person had a tenancy agreement. The maintenance of both houses was the responsibility of the landlord.
The service had a 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.
We spoke with staff who told us they felt supported and that the registered manager was always available on a daily basis and approachable. Throughout the day we saw that people and staff were very comfortable and relaxed with the registered manager and staff on duty. The atmosphere was calm and relaxed and we saw staff interacted with people in a very friendly, affectionate and respectful manner.
Care records 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 healthcare professionals where necessary. We saw people were assisted to attend appointments with various health and social care professionals to ensure they received care, treatment and support for their specific conditions.
We found people’s care plans were regularly evaluated and reviewed with their care managers and updated. The care plan format was easy for service users or their representatives to understand by using pictures and symbols. We saw evidence to demonstrate that people or their representatives were involved in their care planning. We saw one person who used the service had written their own care plans.
The staff that we spoke with understood the procedures they needed to follow to ensure that people were kept safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.
Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff were responsive to people’s needs and wishes. Other professionals we spoke to were positive about the care provided at the scheme.
When we looked at staff training records they showed us staff were supported to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended both face to face and e-learning training to maintain their skills. They told us they had regular supervisions with a senior member of staff, where they had the opportunity to discuss their care practice and identify further training needs. We also viewed records that showed us there were robust recruitment processes in place.
The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005.
We observed people were encouraged to participate in activities that were meaningful to them. For example, we saw staff spending time engaging people on a one to one basis. Others went out shopping in Washington and two people were attending college. We saw holidays had been planned for people using the service. One person told us they were going to Majorca with their family at the weekend.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a selection of choices at breakfast time.
We found the needs of the people who used the service were met.
We saw a complaints procedure was included in the service user’s guide. This provided information on the action to take if someone wished to make a complaint.
We found a quality assurance system in place. The service had been regularly reviewed through a range of internal audits. Prompt action had been taken to improve the service or put right any shortfalls they had found. We found people who used the service, their representatives and other healthcare professionals were regularly consulted about people’s care.