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.