Archived: NAS Community Services (Central London)

This inspection took place on 22 and 24 April 2015 and was announced. NAS Community Services (Central London) is a domiciliary care service providing support to people living in their own homes. The service also operates an outreach service in the London area, providing support to adults at home and when out in the community, 30 people were using the service at the time of our visit.

The service had 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.

The service received referrals directly from family members and/or from social workers providing support to people on the autistic spectrum. An initial assessment was carried out by two senior staff members who had received specific training in the provider’s internal assessment process. Some people’s initial assessments had not been completed or were missing from the care records we reviewed.

Care plans were developed in consultation with people and their family members. Where people were unable to contribute to the care planning process, staff worked with people’s relatives and representatives and sought the advice of health and social care professionals to assess the care needed. This ensured people’s support needs could be identified and met before an individual support plan was developed and staff were allocated to work with people.

People’s risk assessments were completed and these covered a range of issues including guidance around accessing the community and personal safety. People using the service and their relatives expressed positive views about the service and the staff. Relatives felt their family members were safe and trusted the staff providing support and care.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (2005) (MCA) and DoLS, and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others.

Staff had received training in mental health legislation which had covered aspects of the MCA and DoLS. Senior staff understood when a DoLS application should be made and how to submit one.

Staff were familiar with the provider’s safeguarding policies and procedures and able to describe the actions they would take to keep people safe. Staff supported people to attend health appointments and had received training in first aid awareness. There were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being. These included contacting people’s GPs, social workers and family members for additional advice and assistance.

People’s independence was promoted and staff actively encouraged people to participate in activities. People were supported to attend colleges and day centres and to take up work placements. People visited parks and museums, took part in exercise classes, took trips out and went away on holidays.

Staff were required to support people to complete shopping tasks, design menu plans and prepare meals. Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes. Where people were not able to communicate their likes and/or dislikes, staff sought advice and guidance from family members.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. However, we noted that responses to proposed action plans dated February 2015, were still outstanding and therefore there was no clear indication as to how or when service improvements would be undertaken.