Archived: Robert Owen Communities - Domiciliary Care South Devon

Robert Owen Communities –Domiciliary Care South Devon provides support to 60 people with a learning disability in their own homes in the South Devon area. Some of this service is provided to people in supported living services, where small groups of people may choose to live together in a property. It is linked to the larger organisation of Robert Owen Communities (ROC) which is a registered charity and provides support for people with learning disabilities across the Devon and Cornwall areas. Robert Owen Communities –Domiciliary Care South Devon is operated from offices at ‘Aspects’ in Paignton, which also provided day opportunities for people with learning disabilities and a shop for crafts made by people using ROC services. On the days of our inspection approximately 30 people were receiving a service which involved a regulated activity from Aspects, namely personal care. It is this regulated activity that was looked at for this inspection. Other people were receiving enabling support from the service, but which did not involve personal care. These types of services are not regulated by the Care Quality Commission.

On the inspection the service did not have a registered manager in post, as the previously registered manager had left the service three days previously. However, a new manager was in post and had made an application to register with CQC. This person had previously managed this service, was well known to Robert Owen Communities and had worked for them for a number of years. They already had a clear oversight of the role and are referred to throughout this report as the 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.

Robert Owen Communities (ROC) was in process of merging with another care provider. At the time of the inspection the service had moved to be a ‘wholly owned subsidiary’ of United Response, which is a national charity supporting people with a learning disability. We were informed that the transfer would be completed in April 2017 when the service would need to re-register, although work was already under way to merge policies and systems and set up a new organisational structure.

People could expect to receive a service from Robert Owen Communities –Domiciliary Care South Devon that was tailored to suit their individual preferences and wishes. People’s individual goals were identified with them, along with creative plans to ensure their aspirations could be achieved. For some people this included support to take part in activities in their community, both in specialist services for people with a learning disability and also those for the wider community. Innovative solutions had been sought to gather people’ views, and support them to identify new services to meet people’s needs and aspirations. For example, following feedback from people the organisation had developed a scheme to help people receiving support develop skills to enter into the workforce in accordance with their wishes. This listened to people’s aspirations for being a valued working member of society and helped people achieve them.

Robert Owen Communities – Domiciliary Care South Devon had a clear set of values, positive culture and ethos which were shared and understood across the organisation. The vision and values were person-centred and made sure people were at the heart of the service. People were involved at every level of the organisation, and their views were listened to and acted upon.

People's experiences of care and support from the service were overwhelmingly positive. They told us Robert Owen Communities –Domiciliary Care South Devon gave them the help and support they needed and wanted to identify and achieve their goals. People and staff identified with the service’s values and understood Robert Owen Communities –Domiciliary Care South Devon was about supporting their rights and independence.

People we spoke with had a wide variety of needs. Some were living in their own independent flats in the community; others were living in shared supported living arrangements. Some people had communication or physical challenges as well as a learning disability. We saw people and others were kept safe from risks associated with their care through regularly reviewed risk assessments and action plans, including for medicines management. People had opportunities to take risks and develop new skills as a result. For example one person told us how they had been involved in making decisions about risks in their home and while travelling. The decision making had meant the person had greater independence.

People were supported by sufficient staff, at the time they wanted support and who understood their needs. Staff management systems ensured there were enough staff available at all times to ensure people received the care, support and opportunities that they needed and wanted. A full staff recruitment process had been followed for staff working at the service to make sure that staff who were working with people were suitable to do so. People using services had been involved in choosing the staff they wanted to support them. This helped ensure they were compatible, and had led to positive relationships developing.

The service had developed innovative ways of encouraging people to celebrate their successes We saw and heard evidence of staff supporting and demonstrating caring for people way beyond what they could be expected to do. This was celebrated in an annual gala event where people at the service and others within the wider organisation were able to thank and nominate staff for their support that went above and beyond’ expectations. Staff were also able to use this event, which was organised by people being supported, to nominate people who they felt had made significant achievements in the previous year. We saw evidence of the pleasure this had given people, the caring nature of the staff supporting people and of the strong friendships people had built up. We saw numerous examples of staff giving up their personal time to help people have new experiences and develop new skills.

People were supported by staff who had the skills and knowledge to meet their needs. We saw people engaging with staff confidently, and staff supporting people with personal care such as drinking and mobilising. Staff had clear knowledge about how people wanted their care to be delivered, and some people had been involved in training their staff team through multimedia presentations. People being supported could also attend staff training if they chose. One person had done this for medicines recently and was planning to attend training in food hygiene to help develop their personal skills profile.

People were protected from abuse because staff understood how to keep people safe and how to report any concerns about their welfare. People were also supported to understand their rights and manage their own personal safety. For example, we saw people’s rights to make decisions were supported because the service acted in accordance with the Mental Capacity Act 2005 and best interest’s framework. People were given guidance on keeping safe in ways they could understand, and were supported to attend local groups where they could learn about ‘Hate Crimes’ and internet safety. People were being encouraged to have an understanding of rights and inequalities within care. They had been encouraged to give feedback about their views and experiences both to local learning disability services and on a wider level to parliament through projects on citizenship and democratic engagement. They had supported people to develop skills to deliver training to other people with a learning disability about becoming involved in parliamentary processes. As a result some people had voted for the first time. Staff told us it was very important to them that peoples “voices were heard”.

People benefitted from good medical and community healthcare support where this was a part of their plan. This included supporting some people with managing healthy lifestyles. Where people’s care plans indicated they needed support with meals and nutrition plans ensured they received a diet that met their needs and wishes. One person for example told us about how staff had supported them to attend a local sliming group. They had lost significant amounts of weight, which had improved their wellbeing and self-esteem. Staff had helped them shop and cook meals from the club recipe books which they had really enjoyed.

People’s dignity was supported and staff treated people with respect at all times. People’s communication needs were identified and the service worked hard to support people express their wishes. For some people this involved the innovative exploration of technology, such as social media resources, where people could store recordings about their wishes or decision making. For others people were encouraged to take part in meetings, forums or act as service representatives to give feedback to the provider about people’s experiences.

People could be confident that any concerns they raised would be listened to and actions taken to resolve them. People’s empowerment was taken seriously by the organisation, and sel

People we spoke with told us they were given 'plenty of choice about what I do' and that 'staff help me with the shopping'. One person told us that 'staff ask first' and they were able to 'choose what I want to do'.

People that we spoke with said that they knew the names of their carers; one person told us they had been able to choose the member of staff who provided 1 to 1 support. People said they felt staff treated them respectfully and that staff helped them to be as independent as possible 'by holding back'.

People we spoke with said that their opinions were listened to and that the last questionnaires were sent out in November; easy read customer feedback reports were seen.

People's needs and wishes were recorded in a care plans that were kept under regular review. Risks to people's safety were assessed and plans to reduce and monitor risks to both people using the service and staff were in place.

We spoke with four staff in total. Two face to face and two by telephone during our visit. Staff told us that training had improved over the last few months. Staff reported they generally had regular supervision sessions and that they could always get support if they needed it. Records viewed confirmed this was the case.

We were given details about the methods used to check the quality provided to people who use the service such as questionnaires. These were circulated every year to ask people's views of the service.

People we spoke with confirmed they would speak with staff if they were not happy about something. We were told that one of the people had raised a complaint previously with the service. The process for managing the complaint by the service was explained and action taken confirmed that complaints were acted upon appropriately when received.