Larksfield Transitions Unit - Wisbech Also known as mobile 07880783849

Larksfield Transitions Unit - Wisbech is a supported living service. This service provides care and support to people living in one supported living setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service also provides an outreach service to people living in the community. It provides personal care to people living in their own houses and flats. It provides a service to, people with a physical disability, people with a learning disability or autism and people living with dementia. Not everyone using Larksfield Transitions Unit - Wisbech receives the regulated activity of personal care. 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 there were eight people using the service.

The service was very caring. People were at the heart of the service and staff cared for them in a compassionate way. Staff used innovative ways to enhance people’s independence as well as respecting people’s right to privacy and dignity. People were supported and encouraged to use advocacy services. Staff were highly motivated and offered care that was exceptionally compassionate. People were involved in deciding how their care was provided and as a result they achieved exceptional outcomes. People were treated with fairness whatever their needs were.

The service was safe. People were safeguarded by staff who knew how to recognise and report any concerns. The provider identified risks to people and managed them well. Sufficient staff were in post and the recruitment process for new staff had helped ensure that only suitable staff were employed. Lessons were learned when things had not gone well and prompt action was taken to keep people safe. Staff administered medicines and managed them safely. Staff helped people to maintain a clean environment.

The service was effective. Staff met people’s needs and had the right training and skills to do this effectively. People had a varied and healthy diet and enough to eat and drink. People were enabled to access health care services. People were given choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. The registered manager worked with other organisations such as the local authority who were involved in people’s care to help ensure that when people used the service they received consistent care.

The service was responsive. People received person-centred care that was based on their needs. Staff used mobile phones to record their care visits to help ensure people’s care was provided at the time they wanted. The provider encouraged people to raise concerns if and when they arose. Concerns were responded to effectively and helped to drive improvement. Systems were in place to support people and family members with end of life care.

The service was well-led. The registered manager led by example and ensured the staff had the right skills and values. Staff worked as a team to help people and each other. Procedures were in place that were effective in helping the registered manager to identify and act on improvements when these were needed. People had a say in how the service was run. The registered manager provided support to staff in a positive way. An open and honest staff team culture was in place. The registered manager and staff worked in partnership with others including the local safeguarding team.

Further information is in the detailed findings below.

This announced inspection took place on 16 February 2016.

The service had 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.

The service used robust recruitment procedures to make sure that people were supported by staff with the right skills. There were enough staff to support people and to help them access the community. An effective induction process was in place to support new staff in their role.

Staff received regular medicines’ administration training and an assessment of their competency to do this safely. Staff had a good knowledge and understanding of the application of safeguarding procedures to protect people from harm.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had a thorough understanding about determining people’s mental capacity and what this meant for each person. People’s care was provided where it was in their best interests.

Staff regularly sought assurance as to people’s wellbeing and were attentive to their needs. Staff knew what was meaningful and important to people. People’s privacy and dignity was respected by staff.

People, their relatives and advocates, were involved in planning their care. People’s care plans and records were regularly reviewed and updated accordingly. The registered manager provided people with information on accessing independent advocacy if any person required this support.

People were supported with their health needs by healthcare professionals with the right skills, such as occupational therapists, to make a difference to people’s lives. Prompt action was taken in response to the people’s changing health care needs.

Risk assessments to help safely support people with risks to their health were in place and these were kept under review according to each person’s needs.

People were supported with healthy food and lifestyle choices. People had access to sufficient quantities of food, drinks and snacks. Diets according to people’s health conditions were available and provided.

Staff responded promptly to the suggestions, comments or concerns people raised about issues which affected their day-to-day life at the service.

A range of effective audit and quality assurance procedures were in place. These were used as a means of identifying areas for improvement and also where good practice had been established. Information was shared through a range of forums including residents’, managers’ and staff meetings.

Staff were supported with their personal development by managers who kept themselves aware of the day to culture in the service. The registered manager supported staff as well as engaging with people and their relatives on a regular basis. This was to achieve the best possible outcome for each person.

All of the people were independent with their eating and drinking but were checked on to make sure that they had sufficient amounts to eat and drink.

Maintenance and service systems were in place to ensure that people were protected from the use of unsafe equipment. People were satisfied with how they were supported to use the equipment that was made available to them.

Recruitment systems were in place to ensure that people who used the service were safe from unsuitable members of staff. People said that members of staff had treated them well.

People knew how to make a complaint or concern known and had access to information about the complaints procedure, to use if they had a need. Members of staff were also aware of what to do if a person needed support to make a concern or complaint.

People that we spoke with told us that staff always informed them before carrying out any tasks when they were helping to support them. This was confirmed in our observation of the service.

The people who took regular medication were assessed to check their ability to manage and administer their own medicines in a safe way. The assessment indicated the level of support that each person required from staff. During our visit we found that risks to the safe administration of medicines for one person had been identified so that action could be taken to review their level of independence.

We spoke with three members of staff, people who used the service and looked at the duty rota and found that there was adequate staffing to meet the needs of people who lived at the service.

There had been some improvements made to the assessment and care records that were in place although these were not always dated to demonstrate the record was current.