We inspected the service on 17 November 2016 and the visit was announced. We gave 48 hours’ notice of our inspection because we needed to be sure somebody would be available.
Choices Housing Association provides personal care and support for people in their own homes and for those living in supported living schemes or extra care housing. Supported living schemes enable people to be independent with support arranged to meet people’s individual requirements. Extra care schemes enable people to live in their own flats or apartments with support available on site should they require it. At the time of our inspection 102 people were receiving personal care and support.
There was a registered manager in place. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.
People felt safe with the support offered from staff. Staff understood their responsibilities to protect them from abuse and avoidable harm. Risks to people’s health and well-being were assessed to give staff guidance about how to support people to reduce the likelihood of harm. Where an accident or incident did occur, the provider took action to prevent reoccurrences wherever possible. The provider had plans in place to support people to remain safe during emergencies such as a fire.
People and their relatives were satisfied with the number of staff available to offer them care and support. The number of staff the provider employed was enough to provide the care that was planned for each person. Prospective staff were suitably checked before they worked for the provider so that people were protected from those who should not work in the caring profession.
Where people required support to take their prescribed medicines, this was undertaken in a safe way by staff who had received guidance. Staff knew what to do should a mistake occur when assisting people with their medicines.
People received support from staff who had the necessary skills and knowledge. Staff received regular guidance and training relevant to their role. For example, staff received training in epilepsy. People’s food and drink was monitored where this was required to make sure they had enough. Staff knew people’s food and drink preferences. People had access to healthcare services to promote their well-being.
People were asked for their consent when care and support was offered and were supported to make decisions in line with the Mental Capacity Act 2005. Staff understood their responsibilities under the Act including what might constitute restrictions to people’s freedom.
People received support from staff who showed kindness. Their privacy and dignity was protected when receiving care and support. Staff knew the people they offered support to and they were supported to be as independent as they wanted to be. For example, staff encouraged people to do as much for themselves as they could.
People were involved and contributed to the planning and review of their support so that this was centred on them as individuals. The provider told us they were looking to improve the regularity of reviews of people’s support to check that people’s care and support continued to meet their requirements. Where people required additional support to make decisions, advocacy support had been made available to them.
People mostly received care and support from regular staff and at agreed times. The provider was reminding staff to contact people if they were running late. This was identified as an area of improvement when people had offered their feedback to the provider. Staff knew the people they were supporting including their preferences and routines that were important to them.
People and their relatives knew how to make a complaint. The provider had a complaints policy in place that had been made available to people. The provider took action when a complaint had been made.
People felt that the service was well-led. Staff felt supported and received good support from the registered manager. People, relatives and staff had opportunities to give feedback about the quality of the service. For example, questionnaires were sent to people and staff attended meetings with a manager. Where suggestions were received, the provider took action.
The provider had aims and objectives for the service that were known by staff. This included placing people at the centre of their care and support. Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to.
The registered manager was aware of their registration responsibilities including notifying CQC of significant incidents that occurred. The provider checked the quality of the service. For example, checks of people’s care records took place as well as on the health and safety of the care and support provided. The provider took action where required.