We carried out a review of the data available to us about The Integration Trust Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Integration Trust Limited, you can give feedback on this service.
The Integration Trust Limited is a domiciliary care agency providing personal care and support for up to three people living in a specially adapted bungalow. At the time of the inspection two people were using the service.
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 supported by an exceptionally kind, caring and motivated staff team. They were encouraged and supported to achieve personal goals. Staff were very well supported by the registered manager and as a result people using the service received excellent care and support in a very relaxed and homely environment. Staff were extremely dedicated to improving the quality of life for the people they supported and went out of their way to integrate them into their own family lives.
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.
Staff treated people with a high level of dignity and respect. People were given opportunities to be truly involved in all aspects of their daily life and staff provided support patiently to ensure they were given the time and space for this.
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.
People were able to maintain strong family links and relatives told us they felt their loved ones were safe and extremely well supported.
People's care was developed around their wishes, preferences and goals. Support plans contained a very high level of detail which meant staff knew exactly how best to support each person. Each person was truly recognised as an individual and supported in that way. Staff knew the people they supported very well and understood they had very different personalities. People were involved in a wide variety of activities, outings and holidays all of which were carefully chosen to suit each person’s preferences.
Staff were encouraged to develop their knowledge and skills and felt supported and valued.
Medicines were managed safely. There were systems and processes in place to help protect people from the risk of abuse. There were always enough staff on duty to meet people’s needs. Safe recruitment procedures were in place, however, these were rarely needed as there was a very long-standing staff team who had supported the people using the service for many years.
People were supported to have a healthy diet. Specialist advice and input was always sought if there were any concerns about a person’s weight and food was prepared in a way that met any specific needs people had in this area. People were supported to have access to a range of healthcare professionals to ensure they remained healthy.
A range of audits and checks were carried out to monitor the quality and safety of the service. Action was taken if any issues or concerns were identified.
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 11 August 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 Integration Trust Limited is a domiciliary care service that supports three people living with a learning disability and physical disabilities. The three people using the service all share a house together and support is provided 24 hours a day, seven days a week. The service was set up 24 years ago with three families who wanted to ensure their relatives had a good quality of life, could lead an ordinary life and be socially included in their community forming part of the steering group that set the Trust up. It was one of the first such services, in the North East for people with a learning disability.
The service works in partnership with the local authority, NHS services and a local housing association. The Integration Trust Limited trustees worked with a social worker to identify suitable accommodation for people and found a large bungalow in the Brandon area. Over the 24 years the trustees have worked with the housing association to make sure the building was modernised and adapted so it remained suitable for the people who used the service.
There was a registered manager in post at the time of our inspection who had worked at the service since the early 1990s. 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 most striking aspect of this vibrant service was the strong sense of commitment and drive to deliver a service which improves people lives in fulfilling and creative ways. The culture embedded in the service was an absolute commitment to deliver a totally person-centred service, which relatives described as a safe haven. We found that the manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who use the service and staff feeling that they were an integral and essential partner in the operation and enhancement of the service.
We found the staff worked above and beyond what would be expected of a domiciliary care agency or even supported care. We found that the staff had embraced the diversity of people’s interests and views. The understated and tireless nature of the staff actions to ensure people experienced equity in access to the community had led to the people being fully integrated members of the local community.
Staff were devoted to ensuring each individual found their lives were enriched. We found staff empowered people to voice their wants and aspirations for their lives and then supported them to achieve these goals. It was evident that people’s voices were heard. Following feedback from people, decisions were made about who was employed to work with them in their home, activities, holidays and trips were scheduled, and the environment was updated.
Over time as people’s needs changed The Integration Trust Limited had worked collaboratively with people to assist them to ensure their voices were heard by their housing association. This meant the housing association had listened to people and had taken action to ensure their bungalow remained suitable for their needs. Corridors in the bungalow had been widened and rooms converted to create larger usable spaces to accommodate people and their wheelchairs. Most recently, the housing association had devolved the day to day maintenance of the service to the people using it. This meant staff at The Integration Trust had been able to support people to keep the standard of décor within the home to a very high standard. When we spoke with people, they told us they greatly appreciated the support they received from staff and making sure their living environment reflected their choices.
Staff took the time to explore each person’s individual interests. All achievements were celebrated and people were continually supported to achieve their ultimate goals. Even though two people had used the service for over 24 years and another person over five years, staff still identified new and interesting experiences as well as areas for growth they could pursue. People regularly went abroad for holidays, to spas, bowling and tried new experiences such as archery and horse riding. We found this drive to support people to grow and develop was exceptional. Staff took time to make sure facilities for services people planned to use were accessible to them by visiting them prior to the planned visits. Before planned visits to restaurants, staff contacted them to ensure specialised diets could be provided for people and would take a food blender to the restaurant if they needed too to make sure people were involved in all aspects of their visit. This was because the staff did not want people to have a disappointing experience and could join in all of the activity when out.
The service was making a difference to people’s wellbeing by working well as a team, in harmony with one another sharing the same values and principles. The service was proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing. Staff worked with health and social care professionals in ways that benefited people. They were actively contributing to supporting people to understand how to manage their well-being.
The service provided outstanding care to people. Staff were exceptionally caring and inspired people to do well in achieving their goals. People were cared for by staff who knew them well and understood how to support them and maximise their potential. The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. People were listened to and their voice was heard.
Staff understood people's different ways of communicating and how to make people feel valued. They supported people to make decisions for themselves and spoke with people about their wishes and preferences. Staff were observant and reported any changes in people’s needs. They promoted healthy eating and discussed all aspects of physical care with people. They were flexible in adapting the way they provided care, ensuring this was person centred.
One relative who was involved in the development of the Trust and family representatives attend The Integration Trust Limited quarterly board meetings, which trustees also attended. The board members were drawn not only from the families but people with health and social care expertise.
Staff told us they received supervision on a monthly basis and they received annual appraisals. Staff were respected within the organisation and were provided with comprehensive training including specialist training. We found there was a culture within the organisation of striving for excellence and assisting all to reach their maximum potential. Staff were supported to achieve excellence in their roles by attending specialist training around working with people who live with a learning disability and through self-reflection. The provider also supported staff to complete external training.
We found staff had an understanding of safeguarding and how to whistle blow. The manager was aware of risks within the service and was undertaking an analysis of risks. The service had emergency plans in place and took action when they became aware someone was at risk.
Staff safely managed medications. People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. Recruitment checks were carried out. All staff had worked at the service for many years, some of whom, since it opened, which provided consistency for people using the service.
This inspection took place on the 20 and 25 February 2015 and was announced. We gave 24 hours’ notice to the provider as the service is small and we needed to be sure someone was in to facilitate our inspection.
We carried out our last inspection in December 2013 and found the provider was complaint with our regulations.
The service provides 24 hour support to three people who live in their own adapted bungalow in the community. People living in the bungalow rented the property from a local housing association.
At the time of our inspection there was a registered manager in place. 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.
We found safety to be a key feature of the day to day work of the service in their care planning, risk assessments, staff training, working with other professionals and premises management.
We looked at people’s medicines and found they were safely administered.
We reviewed the staff training and saw staff had received sufficient training to be able to care for people in their own home. This included recent training on the use of a defibrillator.
We saw people who were cared for by the service were supported to continue to keep in touch with family members and friends for example; they were supported to send birthday cards to family members and friends.
We found a board member reported to the board their findings of care provided by the agency and acted as ‘next friend’ to represent people’s views at board level. We saw this was delivered in a report to the board.
We reviewed people’s care plans and found them to be personalised along with risk assessments. Staff were aware of the risks to people and how to mitigate those risks.
The registered manager demonstrated by example the determination to ensure people lived comfortably and were kept safe in their home.
The service had in place a number of different systems to ensure the service met the needs of people.
We found the service worked in partnership with a range of different health and social care organisations to respond to, and meet people’s needs.
The provider told us their ethos was to provide a client led service, meeting client’s physical and emotional needs’. We found the service was meeting their overarching goal.
Staff had a clear understanding of the care and welfare needs of people living in the home. A relative described the care as 'very good'.
We saw the equipment in the home was appropriately checked and maintained.
Staff had been recruited using the necessary checks to ensure they were suitable to work with people requiring care.
A complaints process was in place and it had been followed appropriately when a complaint was made
We spoke with the manager at the time of our visit to the office and also spoke with two care workers.
We spoke over the telephone with the relatives of one person who received a service from this agency. Everyone spoke positively about their care workers and felt that they fully supported their care needs.
People told us they were happy with the care and support they were receiving. One person said "I am happy here'. Another person told us he went to a day centre during the week where he enjoyed lots of different activities. He explained that he was a keen football supporter so staff often took him to watch cricket matches.