Archived: Independent Living Alliance - Manchester

There was a registered manager in post who had been registered with the Care Quality Commission (CQC) to carry on a regulated activity since July 2015. A registered manager is a person who has registered with CQC 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 people we visited told us they were happy living in their home and felt safe being supported by the staff both at home and in the community. The registered manager and the staff had a good understanding of safeguarding procedures. They were fully aware of their responsibilities with regards to protecting people from abuse or improper treatment. Incidents of a safeguarding nature had been dealt with appropriately and referred to the local authority. Policies and procedures were in place to ensure the service was operated well.

There were enough staff employed to ensure the people’s needs were met. Team leaders and service managers were employed throughout the provider’s organisation to ensure all services were run safely and effectively. At the time of inspecting this service, there was a vacant service manager’s post. The provider had a rolling recruitment programme to build up a bank of care workers to cover in the event of absences across all services. There was a robust recruitment process in place and we confirmed this process was followed when we reviewed staff records. Staff told us they worked regular shifts and we saw their rotas were planned in advance. This demonstrated people received a flexible, consistent and reliable service.

Care records were very person-centred and contained personalised information. Individual care needs had been assessed and the risks people faced were documented with strategies and actions for staff to follow in order to mitigate those risks. We saw care records were regularly reviewed and updated.

Accidents, incidents and near misses were recorded, investigated, reviewed and monitored by the team leader and overseen by the registered manager. The registered manager was aware of her responsibility to report certain incidents to external bodies, such as the local authority and CQC as necessary. However we found one notifiable incident which had not been sent to CQC. We asked the registered manager to do this in retrospect, which she did.

Medicines were managed well and staff demonstrated that best practice guidance was followed. We observed staff administer medicines in a safe, timely and hygienic manner. Medicine Administration Records (MARs) were used to record when assistance was given. We saw these were legible, accurate and up to date.

The provider had an up to date induction process in place and staff records confirmed they had completed the induction and had shadowed experienced workers. Training in topics which the provider deemed mandatory had been undertaken, such as safeguarding, safe handling of medicines and food hygiene. Specific training in autism awareness, epilepsy and positive behaviour management had been resourced as this was relevant to meet people’s needs. Formal staff supervision sessions, including a probationary review had taken place as well as annual appraisals and regular job chats.

Staff meetings were held every three months with the care workers; monthly team leaders and service managers meetings took place across the provider’s organisation. The staff we spoke with told us they felt supported and valued at work by the management team.

The registered manager and staff displayed an understanding of the Mental Capacity Act 2005 (MCA) and their own responsibilities within its principles; staff had completed MCA training and people’s mental capacity had been assessed. There was evidence that decisions had been made in a person’s best interests with the involvement of relevant others, including through the Court of Protection.

Staff supported people to maintain a well-balanced diet. Most people were supported to shop for and prepare meals depending on their abilities. People were given choices and assisted to plan menus for the week ahead. Staff had been made aware of allergies and food intolerances as well as likes and dislikes. We saw evidence that staff involved external professionals as required to provide input into people’s care.

The atmosphere in the service was calm and relaxed. The staff we spoke with were friendly, caring and professional. They spoke with affection about people they supported and obviously knew them very well. The information they told us matched the information we read in people’s support plans. Staff told us how they respected people’s privacy and maintained their dignity during personal care and we observed them speaking politely to people throughout the inspection. Daily notes recorded by staff reflected caring and respectful values. ‘Personal choice’ reviews were completed with people on a regular basis. These reviews measured the person’s involvement in choices and decisions.

There had been no complaints made about the service. We reviewed the provider’s complaints policy and saw the registered manager had ensured the complaints procedure was shared with people and on display in communal areas. The people we spoke with told us they had no complaints.

There was evidence that the service sought the views of people and their relatives about the service they received. Satisfaction surveys were issued to people and staff for their opinions. Other stakeholders, such as local authority care managers and external professionals were also asked for feedback.

The records we reviewed were accurate and up to date. Records containing people’s personal information were stored securely. Staff records were kept at the provider’s office. Regular audits of the service were carried out by the team leader and evaluated by the registered manager. Provider audits were carried out by representatives from the provider organisation. This demonstrated the provider and the registered manager had oversight of the service and they monitored it for safety and quality.

Staff knew the people they were supporting very well. People who used the service appeared comfortable with the members of staff who were supporting them. Staff told us people received very good care and support.

The home had a safeguarding adult's procedure that complied with all of the relevant legislation and good practice guidelines. Staff understood their responsibilities to protect people from harm.

Records we saw confirmed that the service had effective recruitment and selection policies in place to ensure staff members were of good character and had the required skills to perform their work.

People's records, staff records and other records relevant to the management of the services were up to date, accurate and fit for purpose.

We saw that each person had a 'weekly planner' and this detailed planned activities alongside time to relax and watch the TV or to have a meal. One person who used the service told us that staff always asked them what they wanted to do. They said 'I have a weekly planner. I go out to Middleton and Harpurhey with staff. I like doing that'.

We asked people if they were happy with the care they received and they told us 'Yes' and one person said 'I'm happy with my care'.

We asked people if there was anything that they didn't like about the service provided. People told us 'No'. People told us they had never made a complaint about the service. One person said they didn't know how to make a complaint and another person told us '[a member of staff] said if you're not happy speak to us'.