All inspections: Choice Support Nottingham

This inspection took place on 17 August 2016. Choice Support Nottingham is a supported living and outreach service which provides personal care and support to people in their own home. On the day of our inspection 58 people were using the service.

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.

People felt safe and were supported by staff who knew how to keep them safe. A recent concern shared by a staff member had not been reported in a timely way, although lessons had been learnt following this. Risks to people’s health and safety were assessed and appropriately managed. People were supported by a sufficient number of staff. People received the support they needed to safely manage their medicines and did so with an appropriate degree of independence.

Staff had the knowledge and skills to care for people effectively and felt well supported. People received the level of support they required to have enough to eat and drink and were supported to access a range of healthcare services.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. Where people had the capacity they were asked to provide their consent to the care being provided.

People were treated with kindness and respect by staff. Caring relationships had been developed and people were supported by staff who understood their personalities and the best way to engage with them. People and their relatives were able to be involved in the planning and reviewing of their care. Staff supported people to make day to day decisions.

People were provided with support that was responsive to their changing needs and staff helped people to maintain any hobbies and interests they had. There was a focus of helping people to set and achieve goals and to learn new skills. People felt able to make a complaint and were provided with an accessible complaints procedure. There was an appropriate response to any complaints received.

The culture of the service was open and honest and people and staff gave their opinions on how the service was run and suggestions were implemented where possible. The registered manager acknowledged that they had altered their approach to ensure they were more open to challenge from staff. There were effective systems in place to monitor the quality of the service and ensure that improvements to the service were made.

People could be confident that important events that affected their welfare, health and safety, were appropriately reported so that action could be taken.

We spoke to four people who were using the service. They told us the staff who supported them were respectful and caring. One person said, "The care is excellent. They give me lots of choice and freedom. I have been on lots of trips" Another person said, " Overall the care is very good.'

We spoke to one relative of a person who was using the service and they said, "I feel confident the staff understand my [relative's] needs. There was one carer I did not like, however I raised this and the service dealt with this.'

People told us they felt safe with the support they were being provided. One person said, "I feel safe in their care and I would speak to staff if worried about anything.' People told us they generally liked the staff and staff were able to meet their needs. They also told us they felt they could speak to the staff and they would be listened to.

We found that staff were supported to provide care that met people's needs. Staff received an induction, regular supervisions, an appraisal and a wide range of training to support them within their role.

We found five complaints had been recorded within the last year and a log was maintained to demonstrate action taken in response to the issues raised. The people we spoke to knew how to complain if they needed to do so. Staff also said they felt comfortable raising any concerns.

Two of the three people we spoke with told us that they had been involved in the development of their care plans. One person said, 'The staff are brilliant here.' We did receive feedback from one person using the service who felt that staff were not always respectful. One person said, 'Some staff just walk in without knocking the door and some staff just sit here and do not do anything to help.'

People told us generally staff communicate well and will provide support to access other services including doctor or hospital appointments

People told us they felt safe with the support they were being provided. One person said, "I feel safe and I would go the manager if I were worried about anything.' Upon reviewing records we identified that whilst Choice Support regularly assess and monitor the quality of the services provided by their staff, they did not always take prompt action upon the identification of inappropriate levels of support or care.

The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.

The people whose care we focused on during this inspection were unable to give their views about the service due to their learning disabilities. However we did speak with five relatives of people using the service.

Relatives told us the people who use the service were encouraged to make choices on a daily basis. One relative commented, 'The staff give him choices. They lay out different clothes in the morning so he can choose what to wear. And they show him different meals so he can decide what he wants to eat.'

Relatives said the care the agency provided was good. One told us, 'My relative had a hospital appointment which he was very nervous about. The staff were marvellous. They prepared him for the appointment by getting him a book about going to hospital. Then two of them took him on the day. They were excellent and took the strain off me by taking him.'

Relatives told us they could contact the agency if they had any concerns. One said, 'If I'm worried about anything at all I just ring up and chat to one of the carers.' Another said, '(My relative) is very settled and is always happy to go back after spending time with us so I know he feels safe there.'

Relatives knew about the agency's complaints procedure. One told us, 'I have a phone number I can call if I have any complaints and another phone number so I can take it further if I'm still not satisfied. I've never had to do that though as I tend to deal directly with the carers or their manager if there's a problem. But it's there if I need it.'

Relatives said the staff worked well with them. One relative said, 'The staff are open to suggestions from me and if I suggest something they are happy to try it.' Another commented, 'I never worry about ringing up the carers about anything. They've got a communication book where they record any information I want to share with them. And if there are any issues with my relative from their end the staff contact me and rely on my expertise to help come up with a solution.'

One relative told us there was sometimes a problem with staff turnover at the agency. They said, 'The carers are very good. The only reservation I have is about staff turnover although the staff team does seem to be stable at the moment.' Another relative expressed concern that sometimes a lack of staff meant the people who use the service couldn't go out. They said, 'The staff do there best to help (my relative) follow his interests, although sometimes that depends on staffing levels.'

One relative expressed concern that not all of the people who use the service were able to go on holiday. This was because, they said, staff had to 'volunteer' to take them, and in some cases people needed two carers which wasn't affordable.

Archived: Choice Support Nottingham

All Inspections

17 August 2016

During a routine inspection

During a check to make sure that the improvements required had been made

8 April 2013

During a routine inspection

28 November 2012

During a routine inspection

3 October 2011

During an inspection in response to concerns