Accomplish Group Lifestyles (South West) LImited

Accomplish is a community service that provides care and support to adults of all ages in their own homes.

This includes people with learning and physical disabilities. The service provides some 24-hour live-in care

for people in their own homes. The service also provides outreach support for people who require support

with accessing the local area and work placements. At the time of this inspection the service was supporting

36 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were not easily able to express their views verbally. We spoke with relatives to gather their views of the service provided to their family members. People were consistently positive about the service provided. Comments included, “We are selling our home and are specifically not moving out of the area covered by Accomplish as we don’t want to lose them” and “They [support workers] are absolutely marvellous. They have turned [Person’s name] life around as well as ours. They have saved us all. Everything and anything they need they get.”

Staff were innovative in ways of supporting people with their specific needs. Activities were varied and person centred. People were supported to socialise with friends in their local community. People experienced an improved quality of life with positive outcomes due to the support provided by the service.

People received support from small teams of motivated staff. Staff told us, “I love my job, I have never worked for a company like it, they are very supportive. Help is always at the end of the phone if you need it” and “We consistently support the same people in a team, my team is stable and rarely changes.”

Families and healthcare professionals were complimentary of the service performance and said, “What can I say but just fantastic. [Person’s name] is now a very happy and contented chap,” They now have new meaning to their life. We know they really looks forward to their trips out each day, “Thank you so much it has not only changed A's life it has changed our lives in a big way as well" and "Brilliant great work, please tell the team from us that they are amazing."

Records demonstrated people received their medicines on time and staff understood and met their needs. Information about people’s needs and preferences were recorded in support plans and staff used this information when planning how to support people.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Risks were identified, assessed and reviewed. Staff were provided with guidance on how to manage and mitigate risks while providing support. The service had appropriate procedures in place during periods of adverse weather.

There were enough staff available to provide all planned support. No one reported having experienced a time when staff did not arrive as planned. All necessary recruitment checks had been completed for new staff. New staff completed an induction which involved training and a period of ‘shadowing’ more experienced staff. Training was refreshed so staff were up to date with any changes in working practices.

Support plans were in place for everyone using the service. People and their relatives were involved in the development and review of support plans. The service used an electronic system to hold details of people’s needs but also printed off paper copies for peoples’ homes and the office. The information generated by this system was accurate, timely and detailed.

Families told us staff were caring and treated their family members with dignity and respect. Information about people’s diverse needs was included in their care records. People and their families were supported to express their views to staff and management.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Specific support was being provided to some people to help them overcome their anxiety of being treated by healthcare workers such as doctors and dentists.

Staff were well motivated and there was a positive open culture within the service.

There was a complaints process accessible to everyone. Records showed action had been taken to address and resolve any issues reported to managers.

The service was well led. Management roles were clearly defined and there were effective quality assurance processes in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 September 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The last comprehensive inspection took place on 27 August 2015. There was a breach of the regulations at that time. We were concerned that information held at the service's office including people's care records, staff contact details and service user contact details were not always up to date and accurate. There were shortages of staff at the time of the last inspection which were leading to staff working long hours. This had led to the cancellation of some training, supervision and staff support meetings. This meant some staff had not had regular supervision and support provided. Some training updates were overdue for some staff. The service was not using the Care Certificate for staff who were new to the role.

We carried out a focused inspection 2 March 2017 to check on the actions taken by the service to meet the requirements of the regulation. We judged that the service had taken appropriate effective action and met the requirements of the regulations. The service was rated Good.

Tracscare is a community service that provides care and support to adults of all ages in their own homes. This includes people with learning and physical disabilities. The service provides some 24 hour live-in care for people in their own homes. The service also provides outreach support for people who require support with accessing the local area and work placements. At the time of this inspection the service was supporting 36 people.

The service had been taken over by a new provider and was in the process of transferring paperwork and processes over to the new provider's format.

People told us they felt safe while receiving care and support and reported that staff always respected their privacy and dignity. People who used the service were positive about the people who cared for them.

People confirmed that staff arrived when expected. Comments included, “Most of the time the carers are on time. They let me know if they are going to be late. Usually the Office rings me” and “They (staff) come on time and stay for the right amount of time.”

The service was recruiting new staff to cover vacant posts at the time of this inspection. Existing staff were covering these vacancies. The service did not use agency staff as they felt it was important for the people they supported to have continuity of care staff. We judged that people were not impacted by the staff vacancies. However, as found at previous inspections some staff supervision had not been provided as planned due to staff shortages.

The service operated safe recruitment practices and all staff had received safeguarding training. The providers' safeguarding policy did not contain details of local contact numbers for staff to use if they needed to raise a safeguarding concern. This was addressed by the service during the inspection, with the contact details for the Cornwall safeguarding unit printed and sent out to all staff.

All staff received induction training when they joined the service. The induction was in line with the care certificate. The new provider had asked the service to plan for all existing staff to undertake the care certificate as well as staff who were new to the care role. Training was regularly refreshed and appropriate additional training was provided to help ensure staff remained sufficiently skilled to meet people’s individual needs. Despite some staff supervisions not taking place as regularly as planned, staff told us they were well supported. The service operated an on call manager system to provide staff with any necessary guidance outside of office hours. Staff told us, “The staff meetings are very helpful. If you need help with anything or if something is not working, you can bring it up. At the next meeting we see how things have improved” and “The managers are always available. If they are not around, they can be contacted by phone. Everything I’ve approached them about has been handled professionally.”

Support plans were in the process of being transferred over to the new provider's format. There was a great deal of information held in some people’s care files, some of which was historic. There was also duplicated information which made it difficult to always find the most recent version of a person’s support plan and assessments. Support planning was reviewed regularly and people’s changing needs recorded. People and their families were involved in any reviews.

People were supported to take part in varied activities and attend work placements that they enjoyed.

The registered manager was supported by two project managers and three team leaders and an office administrator. People were provided with information to support them to raise any concerns they may have. The service did not have any formal complaints at the time of this inspection.

We undertook a focused inspection on the 2 March 2017 to see what actions the provider had taken to address the concerns from the last inspection and to confirm they now met legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Embrace on our website at www.cqc.org.uk

Embrace is a community service that provides care and support to adults of all ages, in their own homes. The service provides help with all aspects of people’s personal and social care needs in the Cornwall area. This includes people with learning and physical disabilities. The service provides some 24 hour live-in care for people in their own homes. The service also provides outreach support for people who require support with accessing the local area and work placements.

At the time of this focused inspection the service was supporting 37 people.

There was a registered manager in post. 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.

At this focused inspection we found the registered provider had taken the necessary action to meet the legal requirements. The care plans held at the service office were up to date and provided current information on the needs of each person. Daily records were regularly returned to the office for auditing and filing. The service was able to provide an accurate contact list for all the people receiving a service and also all the staff currently providing support to them. Staff had received regular supervision and appraisals since the last inspection. Training updates were now recorded for each member of staff and held on a record that was monitored by the registered manager. This meant that updates were provided in a timely manner. All staff were up to date with their training requirements. The Deprivation of Liberty safeguards policy had been reviewed and now reflected current guidance.

We met with four people who used the service and spoke to two relatives to seek their views of the service provided. People who used the service and their relatives were very positive about the care and support they received. Three people told us they were very happy with they support they received. One person said, "X is very helpful they help with whatever I ask". One relative told us, "I have nothing but praise for the team that support X". Another relative told us, "X is very happy, they are well looked after".

The staff we spoke to were positive about management support and the quality of the service provided to people. Staff were knowledgeable about people's individual needs.

Records kept in staff files showed us all appropriate pre-employment checks were carried out. This meant people were protected by an effective recruitment process.

The provider had satisfactory quality assurance systems in place that ensured people were safe and improvements could be made as necessary. On the day of the inspection, staffing levels were satisfactory.

People were very positive about the care and support they received. For example one person said ‘It is much better being in my own place, than living with other people…the staff are very good…they are always very helpful to me’. A relative of a service user said ‘We have a very dedicated team; they provide us with an excellent service’.

We also spoke with several staff who worked in the service and they were also positive about the service. One X said ‘all the services are very different…they are individualised according to what people want…management are very supportive and the training is excellent’.

Documentation regarding the service provided was to a good standard. For example care plans provided clear information regarding care and what support staff needed to assist people with.

At the time of the inspection staffing levels were satisfactory, and there was evidence that suitable staff recruitment checks and staff training were to a good standard. The service also had a satisfactory quality assurance system in place which should ensure the service was maintained to a good standard and improvements were made as necessary.