Archived: Somerset LD Services 1

Somerset LD Services 1 specialises in providing supported living and domiciliary care services to adults who have a learning disability or autistic spectrum disorder. The agency provides supported accommodation services in Frome and Shepton Mallet. They also provide a domiciliary care service to people living in a range of settings across Somerset. This part of the service was recently inspected during inspections of Somerset LD Services 3 and Somerset LD Services 5. Therefore we did not cover the domiciliary care part of the service during this inspection.

During this inspection we visited people living in supported living complexes in Frome and Shepton Mallet. Their accommodation was provided by separate housing providers or landlords, usually on a rental or lease arrangement. The housing services are not regulated or inspected by CQC. People could choose an alternative support service provider if they wished while continuing to remain in their current accommodation.

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 told us the staff were kind and caring and they felt the staff supported them to remain as safe as possible. A relative praised the staff and said they were confident people were safe from harm or abuse. They told us “The staff are all caring. Never a harsh word said to anyone.”

Staff had received training on safeguarding adults and knew how to identify and report any suspicion of abuse. .

People received reliable and consistent support from a stable and well trained staff team. Each supported housing complex had a team of staff based there. People could choose the staff they wanted to support them. They had been consulted and involved, as far as they were able, to draw up and agree a plan of their support needs. Each person either held, or had access to their support plans and records of their health and personal care needs. Staff were expected to read the support plans and provide support in accordance with the person's wishes. People told us there were enough staff employed to meet their needs.

People had access to a range of health professionals. Where people's health needs had changed, staff worked closely with other health professionals to ensure they received support to meet their needs. Each person was supported by staff to receive regular health check-ups and treatment from doctors and health professionals. Staff knew how to identify potential health problems and supported people to seek medical attention promptly.

Each person received support to help them manage their medicines safely. Staff had received training and support to ensure they followed safe practice when administering medicines. Records of medicines administered had been well maintained.

People were supported by staff who had received a range of training that provided them with the knowledge and skills to meet each person's health and personal care needs effectively. Staff received regular supervision and support. They were positive and enthusiastic and told us they enjoyed their jobs. Comments from staff included “We’ve got such a good team,” and “I think it runs very smoothly. We know what we are doing. Everyone is very helpful.”

Where people lacked the mental capacity to make certain decisions the service ensured their human rights were protected. All of the interactions we observed between people who used the service and the staff were friendly and caring. Staff sought people's consent before providing support. People were offered choices on all aspects of their daily routines.

People led active lives. Staff had supported each person to help them identify and plan the activities they wanted to participate in each week. People were supported to participate in activities in their local communities, including work, education and leisure activities. They went on group or individual outings and also enjoyed a range of activities in their own homes. We heard about parties, outings and holidays. People were also supported to keep in touch with friends and families.

The service was well led. The provider had an effective quality monitoring system to ensure standards of service were maintained and improved. People were involved and consulted about all aspects of the service. A social care professional told us “My experience of this (service) is nothing but positive. The staff are professional, experienced and provide exceptional support to customers.”

Staff used people's preferred methods of communication to help three people give us their feedback. People told us how the staff supported them. For example, daily decisions such as what they ate, their appearance and activities. Two people living in supported living environments told us staff were helping them to manage their medicine and their finances.

Where people had capacity to give valid consent the staff supported them with their decisions. Where significant decisions needed to be made Mental Capacity Act 2005 (MCA) assessments were completed to determine whether people had an understanding of their decisions. For example, management of medicines and finances. Where people lacked capacity to make decisions about where they lived Court of Protections applications were made. This ensured best interest decisions about where people lived were made on their behalf.

People knew they had a care file. One person told us the staff told them what they recorded and two people told us they were fully involved in developing their care plans. The managers of the locations we visited were to attend person centred training to enable them to develop personalised care plans.

The management of medicines was effective and where people were able they were helped to self-administer their medicines. One person told us they administered their own medicines and staff supervised them to ensure they had taken their medicines correctly. Another person told us they had received support from the staff and were competent to manage their medicines. A third person told us the staff were supporting them to self-administer their medicines.

People told us they would tell the staff if they were not happy. One person told us they felt confident the staff would take their concern seriously and act on what they said. Where people were not able to verbally communicate staff f knew when people were not happy by the behaviours people exhibited. Staff told us they listened to people's concerns and passed the information to their managers for action. The records of complaints showed when people raised concerns or complaints action was taken to resolve

People confirmed they received the care which was described in their care plans, but staff said the care plans were too brief. One person showed us their activities board which was in pictures. This described their daily routines and activities with the staff who were to support them. Another person showed us their 'remind me' file which said the agreements made with the staff. For example, how to control their behaviour and promote choices and privacy.

People said 'I like the staff,' 'the staff are ok' and 'I get on ok with the staff.' They told us they felt safe with the staff and they would approach them if they had a complaint.

Staff who worked at the agency had to attend essential training to ensure they had the skills to meet the needs of people that used the agency. Staff told us their training needed to be updated and the records showed not all staff had attended refresher training.