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Community Support Service Outstanding

Reports


Inspection carried out on 22 January 2019

During a routine inspection

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 health

Inspection carried out on 9 June 2016

During a routine inspection

We inspected Community Support Services on 9 June 2016 and the visit was made at short notice to make sure the registered manager would be available.

The last inspection took place on 21 October 2014 and at that time the service was meeting all of the regulations we looked at.

Community Support Services (CSS) provide day services, supported living, outreach and domiciliary care services to people with learning and/or physical disabilities. At the time of our inspection they were providing support to 112 people, only 12 of whom were receiving personal care which is the part of the service the Commission regulates.

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.

People who used the service told us they felt safe with the care they received. We found there were appropriate systems in place to protect people from risk of harm.

There were policies and procedures in place in relation to the Mental Capacity Act 2005 and Deprivations of Liberty Safeguards (DoLS).

We found that people were provided with care and support by staff who had the appropriate knowledge and training to effectively meet their needs. The skills mix and staffing arrangements were also sufficient. Robust recruitment processes were in place and followed, with appropriate checks undertaken prior to staff working at the service. This included obtaining references from the person’s previous employer as well as checks to show staff were safe to work in the care sector.

Staff had opportunities for on-going development and the registered manager ensured they received induction, supervision, annual appraisals and training relevant to their role.

The staff we spoke with were able to describe how individual people preferred their care and support delivered and the importance of treating people with respect in their own homes.

People using the service and relatives told us staff were reliable, kind and caring and always provided care and support in line with the support plan in place. We found staff provided a person centred service.

The care plans we looked at were person centred and reviewed on a regular basis to make sure they provided accurate and up to date information. The staff we spoke with told us they used the support plans as working documents and they contained sufficient information to enable them to carry out their role effectively and in people's best interest.

Medicines management systems were in place to ensure people received their medicines at the right times. When necessary staff offered appropriate support to make sure people’s healthcare and dietary needs were met.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

People using the service, relatives and staff we spoke with were very positive about the registered manager. They all said the registered manager was committed to providing the best service they could offer, was approachable and provided effective leadership. People told us they would recommend the service to other people.

There was a quality assurance monitoring system in place that was designed to continually monitor and improve the service provision.

Inspection carried out on 21 October 2013

During a routine inspection

At the time of the visit only three of people supported by the agency were receiving personal care. They all had complex needs which meant that they were not able to tell us their experiences. We spoke with two relatives and two members of staff who were delivering personal care. These were some of the things they told us:

�We have a regular team of carers that are reliable and know what they are doing. When we have had any problems these have been dealt with.�

�The staff are very good and are reliable. We are fully involved in the care planning and communication is good.�

�I enjoy working for the company, it is very friendly.�

People and/or their relatives had been involved in planning their care and support. People told us that staff were respectful and mindful of their dignity.

We found that parents had been involved in developing care plans and risk assessments and had given their consent for staff to deliver care and support outlined within those plans.

There were systems in place to make sure that people were kept safe and procedures for reporting any suspected abuse.

Our conversations with people and staff indicated that staff were well trained and that they felt supported in their role.

We found that there was a complaints policy in place and that people knew how to complain if the need arose. Concerns that had been raised had been dealt with and resolved to the complainants� satisfaction.

Inspection carried out on 3 July 2012

During a routine inspection

We carried out an unannounced inspection at the regional head quarters for this service on 03 July 2012. We looked at the care records, systems and processes for safeguarding, staffing, and quality monitoring. We visited the day care centre and one of the supported living homes.

During the visit, we spoke with nine staff and seven people who use the service; we observed people�s care and looked at five care, treatment and support records.

People who use the services told us that they got on well with the staff. Staff were friendly; they felt that the staff treated them with respect and promoted their independence by involving them in making decisions about their support plans and treatment choices.

They also told us that the service managers involved and included them in spot check visits to review their support workers and the service they provide. One person said, �The staff are excellent�. Others told us that the staff were kind, helpful and they saw the staff as their friends.