This inspection took place on 3 February 2016 and was announced. Turning Point - Derby is registered to provide personal care and support for people with a learning disability and autism. At the time of our inspection there were 13 people using the service who resided within their own home. People’s packages of care varied dependent upon their needs, in some instances people were supported over a period of 24 hours.
People who used the service were unable to consent to our visiting and meeting with them to talk about the service due to their complex needs. We were advised that our visiting some people within their own home may cause people potential distress and anxiety, as people were not comfortable in the presence of people they did not know. We therefore spoke with a relative of someone who used the service and the staff who provided support.
Turning Point – Derby had 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.
The inspection was facilitated by the supported living manager and regional manager as the registered manager was not available on the day of the inspection.
People we consulted told us they believed people’s safety was promoted and recognised by the support workers. Staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service. Where people were at risk, staff had the information they needed to help keep them safe.
People were supported by knowledgeable staff that had a good understanding as to people’s needs. Staff provided tailored and individual support to keep people safe and to provide support if their behaviour became challenging. People were supported to take ‘positive risks’ to promote their independence in leading a lifestyle of their choosing.
People were supported to take their medicine by support staff. People’s capacity to make informed decisions about taking some medicines had been assessed and best interest decisions had been made. This was to ensure people’s needs were met when they themselves were not able to promote their own safety and welfare by making an informed decision.
People using the service had a dedicated team of staff that provided support to them within their own home and the wider community. People’s views as to staff along with those of their relatives were considered to ensure the staff that supported people had the appropriate skills and were able to develop a positive and trusting working relationship.
People received an effective service as people’s support plans provided clear guidance about their needs. These were monitored and reviewed by the management team and team leaders through the supervision and appraisal of staff, staff meetings and quality monitoring audits.
People were provided and supported in line with legislation and guidance. Staff had received training on the Mental Capacity Act (MCA) 2005. We found that capacity assessments had been carried out on aspects of people’s care and support. Where these assessments had identified that people did not have the capacity to make an informed decision, then their relatives and others involved in their care had an agreed plan of action so ensure any decisions taken were in the person’s best interest.
People were supported with daily living tasks such as grocery shopping, meal preparation and cooking as part of their support packages. Staff encouraged people to eat a healthy diet. People’s dietary requirements along with their likes and dislikes with regards to food and drink were recorded within their records.
Records showed staff, where support was required, liaised with people’s health care professionals to ensure they had access to appropriate medical care and support.
People were supported by staff who knew them well and had developed positive and trusting relationships that been established between the people receiving a service, their relatives and staff. Staff told us that part of their role was to support people to access the wider community and to encourage social interaction and independence. In discussion staff told us how they supported people’s privacy and dignity within the wider community and worked with them to promote their independence.
People’s support plans were tailored and individualised to meet their needs and reflected all aspects of their lives, including information and guidance as to the support they required within their own home and the wider community. People’s preference as to their hobbies, interests, goals and aspirations were also reflected.
Support plans were comprehensive and focused on the views of the person and how they wanted their support to be provided. There was an emphasis on the need for good communication to ensure people’s views were clearly understood which included information for when people’s behaviour was challenging.
Staff spoke positively of the management team in the support they provided to them. Staff said issues were effectively managed to ensure people received a good service. Staff said there were effective systems which enabled them to communicate well with their colleagues to ensure that people received the support they needed.
The managers who facilitated the inspection had a comprehensive understanding as to the needs of people and were able to tell us how staff provided support.
The provider had a robust quality assurance system which assessed the quality of the service. Information gathered as part of the quality audits was used to continually develop the service and looked for ways in which people using the service could achieve greater autonomy.