Freetime Care Services Limited

The inspection took place on 13 November 2018 and was announced. At our last inspection on 18 February 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

We found that Freetime Care Services Limited reflected the values that underpin Registering the Right Support. By this we mean the provider had developed their service to ensure people with learning disabilities and autism are supported to live as ordinary a life as any other person. They are provided with choice and there is promotion of inclusion.

Relatives were happy their family member was safe using this service. Staff knew how to recognise and report abuse. Risks to people’s safety were well managed and included those risks associated with using community amenities so that people could undertake these safely and without any restrictions. Consistent staffing levels ensured people had the support they needed in their own home. Recruitment processes remained safe with checks in place to ensure staff suitability. The provider did not currently support people with their medicines but staff were trained to do this. Staff followed infection control guidance when supporting people in their own homes. There were processes in place to improve people's experiences when things went wrong.

People were involved in identifying their needs and received support from staff who continued to receive regular training. Staff understood how to support people with eating and drinking and the risks associated with this. People had support to maintain their health and staff were proactive in supporting them to access healthcare services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by staff who were caring and attentive and respected their diversity and choices. Staff promoted people's preferred communication methods to ensure their individual choices were fully respected. Staff had a thorough understanding of promoting and respecting people's privacy, dignity and independence.

Care and support was responsive to people’s needs and provided in a person-centred way. People were involved in the planning and reviewing of their care, and supported to follow their recreational interests. Relatives told us they felt confident to raise a complaint.

The provider had a clear management structure and had actively adapted their service to benefit the lives of people using the service. There was a focus on continuous improvement which was reflected in their development of the service. The provider worked in partnership with several other agencies to ensure people received the right support. Staff felt supported and valued in their work. There were systems in place to monitor the quality of the care provided and to ensure people received quality care.

Further information is in the detailed findings below.

Freetime Care Services Limited provides personal care and support for people with learning disabilities who live in their own homes. At the time of our inspection two people received care and support. Some people had autism and needed support with their complex needs and behaviour.

The services to people varied from daily support in their home to providing respite support in their own home.

CQC regulates the personal care activity that Freetime Care Services Limited provides to people in their own home. This report relates only to these activities and not the day care provision provided from this location.

At the last inspection in July 2014 the service was meeting the regulations that we looked at.

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.

People were supported by staff who had been trained and understood their role and responsibilities in protecting people from harm or abuse. The safety of people who used the service was taken seriously. Risks to people’s safety and wellbeing were identified and addressed.

Staff were recruited in a safe way and there were enough trained and experienced staff to support people and meet their needs in a personalised manner. The management team monitored staffing levels and provided enough staff to support people safely in their own home. There was an effective out of hour’s support system for staff from the management team to ensure people’s well-being.

Staff were not required to support people with their medicines on a regularly basis. We saw staff had been trained in medicine management and that policies and procedures were in place and checks were undertaken to ensure staff practiced in a safe way.

We found staff had excellent access to training to meet people’s individual and sometimes complex needs. People had consistency and continuity from staff who had been matched with them. External professionals told us that they were highly impressed with the training and competencies of staff.

There was a proactive support system in place for staff. The registered manager had created a clear structure so that staff received regular supervision as well as ‘team’ opportunities to reflect on their practice. Staff felt extremely well supported and there was a system for recognising and awarding staff for their performance.

People were supported to understand information about their care and support. People’s preferred methods of communication had been considered and they were involved in identifying their needs and how they would like to be supported.

People’s consent to care and support was sought and respected. We saw people were encouraged to make their own decisions and staff understood the need to seek their consent.

People were supported by staff who understood their particular eating routines and the importance of maintaining a healthy diet. People maintained control over their own health care needs with the support of their relatives. There were excellent links with healthcare professionals and we saw staff sought professional advice so that people experienced good health outcomes that promoted their wellbeing.

People were supported by staff who knew them well were kind and encouraged them to remain living in their homes. People were actively involved in planning their care and in providing feedback on the service. Staff understood and promoted people’s privacy and dignity when delivering personal care in their home.

There was an excellent understanding of the importance of putting people first. Staff were responsive to people’s specific needs and the service was organised around people’s preferences. We received some outstanding feedback from relatives and professionals who described the service as unique.

People were very complimentary about the management approach and attitude of the registered manager. The registered manager had used their knowledge about the needs of people using the service to tailor the support to people in their own home. Staff had an excellent understanding of people’s diversity and had been innovative in gaining people’s trust so that people could accept support in their own homes.

The structures in place enabled the registered manager to deliver the support people wanted and needed. Quality monitoring systems were effective and checks were completed to ensure improvements were identified and actioned. People using the service, their relatives and staff were actively encouraged to contribute to the evaluation of the service and make recommendations for improvement. There was a consistently high level of positive feedback from people who used the service. People felt they received consistent personalised care and support.

We inspected this service to ensure that potential risks to the safety and wellbeing of people were being managed effectively. At the time of our inspection Freetime Care Services Limited was providing a service to two people in their own homes. Due to the support needs of both people we were unable to gain feedback directly from them. We carried out telephone interviews with each person's representative. We spoke with three community facilitators, the assistant care manager, a senior team leader and the registered manager.

This is a summary of what we found

Is the service safe?

People using the service and their representative expressed confidence with the service.

Staff completed an induction and had access to regular training. They had the opportunity to 'shadow' experienced staff prior to be being allowed to work unsupervised. This meant that the provider could demonstrate that all staff employed were suitable and had the skills and experience needed to provide personal care to people in their own homes.

The registered manager organised staff rota's to promote continuity of care. This included consideration of the staffing levels needed to ensure that people's needs were met.

Is the service effective?

Representatives of the people who used the service told us that they knew all the carers who supported their relative by name. They said they had the same staff and this provided consistency.

They told us that they were involved in the planning and the review of support plans. One person we spoke with said they were: "Very happy with the support plan and staff worked well with their family member; understanding their specific needs'. Another representative told us, 'My relative is really happy with this service and as a family we have the support in our home we need, we also have a copy of the plan and any changes'.

We saw systems were in place to spot check staff competencies in delivering personal care.

We saw that daily records were kept of the support delivered to people in their own home. Representative's told us they also had a copy of this and confirmed staff stayed for the required amount of time and completed the agreed care tasks.

Is service caring?

We spoke with the representatives of people who gave positive feedback about the staff. One representative said: "This is the first provision where staff has emotional intelligence; they treat my relative as a person, a fantastic model, they understand and respond so well to my relative's needs'.

Is the service responsive?

The provider had worked with other agencies and the support plans included guidance received from other health professionals. We saw some assessment information which indicated the need to review risks to people's safety.

We saw that systems were in place to assess people's needs and devise a support plan detailing their needs. A support plan was in place for each person being supported. Both representatives we spoke with said they were happy with the support plan. The representatives of people using the service told us they had regular meetings to discuss and review support plans. They felt the service responded to their relatives needs when providing personal care in their home.

The representatives we spoke with told us they were happy with the care and support provided to their relative. A representative told us, "We are very happy with everything. We attend the reviews and contribute to the way the support and care is provided. We have no concerns."

Is the service well led?

Staff we spoke with were able to tell us about people's needs and how to meet these. The registered manager had demonstrated that staff rotas took people's care needs into account when making decisions about staff numbers, qualifications, skills and experience required. The provider had ensured staff received training relevant to their role. This helped to ensure that people's needs were responded to by sufficient numbers of staff with the right skills.