9 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 22 and 23 January 2019 and was announced. We gave the service 48 hours’ notice of the inspection visit because the registered manager is often out of the office supporting staff or visiting people. We needed to be sure that they would be in.
The inspection team consisted of one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Prior to the inspection, we gathered information from several sources. We reviewed the information we held about the service, which included correspondence we had received and notifications submitted to us by the service. A notification should be sent to CQC every time a significant incident has taken place. For example, where a person who uses the service experiences a serious injury. We reviewed the Provider Information Return (PIR), which the registered provider completed before the inspection. The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
We contacted Calderdale local authority to obtain their views of the service. All the comments and feedback received were reviewed and used to assist and inform our inspection
On 22 January 2019, we visited two day centres, two supported living homes and the home of one person who lived with their parents. We spoke with seven people who received support and two relatives of a person who received support to ask their opinions of the service. We spoke with the registered manager and five staff about their roles and responsibilities. This included a house manager, the outreach manager and three support workers. We also checked three people’s support plans and care records at the office base.
On 22 January 2019, we telephoned people who received support to ask their opinions of the service. We spoke with five people supported by the service and seven relatives or representatives of people receiving support, to obtain their views of CSS.
On 23 January 2019 we visited the service’s office. We spoke with the registered manager, a supported living house leader, a support worker, the outreach manager, the performance and wellbeing manager, the deputy office manager and the admin manager. We reviewed a range of records, policies and procedures. These included staff training and supervision records, three staff employment records, and other records relating to the management of the domiciliary care agency and the supported living service.
9 March 2019
We inspected Community Support Service (CSS) on 22 and 23 January 2019.
The inspection was announced. We gave the registered provider 48 hours notice of our inspection to make sure the registered manager, some staff and some people receiving support would be available to meet and speak with us.
The last inspection took place on 9 June 2016. The service was rated Good.
CSS provide day services, supported living, outreach and domiciliary care services to people with learning and/or physical disabilities.
Part of this service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community.
Part of this service provides care and support to people living in four ‘supported living’ settings, so that they can live in their own home as independently as possible. 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.
Not everyone using CSS receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, the service was providing support to 165 people. Twenty people were supported with personal care.
There was a registered manager in post, who is also one of the directors of the company. 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 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.
We received extremely positive views from people about the support provided to them or their family member. Without exception, people told us they felt safe and their care workers were extremely respectful. People told us they received support which had a very positive impact on their life. Staff demonstrated they were highly motivated and offered care and support that was compassionate and kind. All staff displayed a sense of pride and outstanding commitment to the service and the people they supported. The service was exceptionally caring. People felt they mattered and they contributed to the service.
We found systems were in place to administer people’s medicines safely. Involvement with health professionals and initiatives to consider medicines administration had had a very positive impact on people's health and well-being.
People were encouraged and supported to take positive risks to allow for an unrestricted and meaningful life.
Robust recruitment procedures were in operation and promoted people’s safety. People receiving support were actively involved in the recruitment procedures.
Staff were provided with relevant training, supervision and appraisal for development and support. People receiving support were actively involved in the provision of staff training. This had a very positive impact on the staff receiving training.
There were appropriate numbers of staff employed to meet people’s needs and provide a very flexible service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice. People had consented to receiving care and support from CSS.
People were supported to maintain a healthy diet, which considered their culture, needs and preferences, so their health was promoted and choices could be respected. Access to healthcare professionals was supported.
People said they could speak with their care workers or the registered manager if they had any worries or concerns and they would be listened to.
The registered manager was an excellent role model. They displayed a strong commitment to providing high quality care to people, which was shared by staff. They had innovative ways of promoting a positive culture and involving people in the service. The registered provider demonstrated partnership working to improve and develop the service. We found an effective system was in place to monitor service delivery. The management team placed strong emphasis on the importance of not only supporting people but their family members also. They were described as supportive and approachable and always putting the needs of people first. They showed a continued desire to improve on the service and worked closely with other agencies and healthcare professionals to do this.