United Response - West Sussex DCA

This service provides care and support to people with a learning disability in two ‘supported living’ settings, so that they can live in their own home as independently as possible. This consisted of two residential houses which were within walking distance of each other. The houses were close to local amenities of shops and transport routes. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the inspection seven people lived in the two supported living houses but only four of these received personal care and support. Each person had their own private bedroom and shared other areas of the house with the other occupants. This consisted of the kitchen, lounge and dining areas plus bathrooms and toilets.

At our last inspection we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

Risks to people were assessed and there were measures in place to ensure people were protected against any identified risks.

People said they were supported well to maintain and develop their independent living skills and said they felt safe at the service. Staff were trained in safeguarding procedures and had a good awareness of the importance of protecting people.

Medicines were safely managed. Sufficient numbers of staff were provided and checks were made on the suitability of new staff to work in a care setting. Staff were trained in infection control and prevention. The provider had a system for reviewing any incidents or accidents.

The provider supported staff with a range of training courses including nationally recognised qualifications in care.

People’s nutritional needs were assessed. People prepared their own meals with staff support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Support was provided to people to live independently.

Staff had a good awareness of people’s rights to care and to be treated equally irrespective of any disability, age or sexual orientation. People were involved in decisions about their care. People’s privacy was promoted.

People received responsive care which met their individual needs and preferences. People were supported to attend social and recreational activities.

There was a complaints procedure, which was provided to people who said they were able to discuss any issues or concerns they had.

The service was well led. The culture of the service supported people to take part take part in how the service ran and in providing person centred care which helped people develop independent living skills. There was oversight of the service by the provider organisation and staff were supported to develop their skills and knowledge. There was a system of checks and audits regarding the safety and quality of the service.

Further information is in the detailed findings below.

We inspected this service on 23 and 29 February 2016 and the inspection was announced. This was to make sure there would be someone available in the office to facilitate our inspection.

The service had a registered manager who had worked at the service for many years. However they were not at work at the time of the inspection and we were told they had handed in their notice. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. A senior member of staff facilitated the inspection with support from the area management team.

People were supported by kind, caring staff that knew them well and understood the importance of supporting people to lead the lifestyle of their choice. People’s independence was promoted and they participated in a range of activities of they had chosen . People could choose and were supported to plan and prepare their own meal and help themselves to drinks when they wanted. One person told us “I can do most things myself but I get support from staff when I need it. I like to be independent”. Another person told us “It’s the best thing I ever did moving here. I like living here and I like the staff”.

People’s needs had been assessed and planned for with the person. Plans took into account people’s preferences, likes and dislikes and were reviewed on a regular basis. Staff worked in accordance with the Mental Capacity Act (MCA) and associated legislation. People were supported to make their own decisions. One person told us “They (the staff) never make me do anything, it’s my own choice, I decide”.

People were supported to maintain relationships with people that mattered to them such as their friends, family and people from the local church. Each person had a named key worker who helped them to co-ordinate their support needs and plan for their future. One person told us “It’s a wonderful place, I love it here the staff support me to be independent”. People were supported to access the service of medical professionals and make and attend health care appointments when needed.

Care was centred on people’s individual needs and that principle governed the day to day management of the service. One staff member told us “The main thing is being person centred and we are. We put people first in everything we do. We look at their values, their rights, support them to make informed choices and develop their skills”.

Staff received the training and support they needed to undertake their role and were skilled in supporting people to become more independent. Staff had a good understanding of each person’s needs and of how some people their feelings. They were able to recognise when a people were feeling anxious and took appropriate action to offer reassurance and emotional support. Staff knew what action to take if they suspected abuse had taken place and felt confident in raising concerns. Risks to people were identified and managed in the least restrictive way so not as to unnecessarily impact on their freedom.

People and staff spoke highly of the management and the support they received from them. A member of staff told us “We are surrounded by very good managers who are very helpful, caring and supportive.” The management of the service were was open and transparent and a culture of continuous learning and improvement was promoted. The provider had ensured there were robust processes in place for auditing and monitoring the quality of the service and complaints were responded to appropriately.

The service followed safe recruitment practices and staffing levels were sufficient to meet people’s assessed needs, including spending one to one time with people. Medicines were ordered, administered, stored and disposed of safely by staff who were trained to do so.

During our visit we talked to two staff members, two people using the service and the service manager.

We observed interactions during our visit and saw that people were offered choices on how they wanted to spend their time.

We saw people being addressed in a respectful manner.

We examined support plans of people using the service and saw that the information recorded enabled staff to deliver individualised care.

We saw evidence of regular audits of the service completed by the provider which showed that the quality of the service was regularly monitored so that services could be improved for people.

Staff told us that they received regular training and felt supported in their roles.

People using the service told us that they were happy and supported in their homes.

We made observations throughout the visit and saw people being offered choices as to how they wanted to spend their time.

We saw people being addressed in a respectful manner. We looked at peoples individual support plans and saw that the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

A person who was using the service told us "the staff were very good" and "they help me when I need it."