Archived: SeeAbility - Meadowmead Support Service

SeeAbility - Meadowmead Support Services provides personal care and support to people in their own homes.

At the time of our inspection the service was providing a service for nine people with a variety of care needs, including people living with sight loss and learning disabilities. Some people had very limited verbal communication skills.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People felt safe living in their home with support provided by SeeAbility - Meadowmead Support Services, and they were very much at the heart of the service. We received positive feedback from people, relatives and professionals about the care provided.

Overall, improvements had been made to staffing since our last inspection and the service was continuing to recruit the right staff for the people they support.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills.

Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse.

Medicines administration records (MAR) confirmed people had received their medicines as prescribed.

Staff received support and one to one sessions or supervision to discuss areas of development. They completed training and felt it supported them in their job role. However, the impact of the COVID-19 pandemic had reduced some face to face training and the provider had taken action to minimise the impact on people.

Staff had developed positive and caring relationships with people and their families. Staff were highly motivated and demonstrated a commitment to providing the best quality care to people in a compassionate way.

The provider’s quality assurance system helped the management team implement improvements that would benefit people.

There were appropriate management arrangements in place and relatives and professionals were very positive about the management in the home.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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 requires improvement (published 25 May 2019).

Why we inspected

The inspection was prompted in part due to concerns such as medicines and staffing. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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.

At the time of our inspection the service was providing a service for eight people with a variety of care needs, including people living with sight loss and learning disabilities. Some people had very limited verbal communication skills.

People’s experience of using this service:

People using the service told us they felt safe. Staff completed training in safeguarding and could recognise signs and symptoms of possible abuse in people.

We received concerns that the service had insufficient staff to keep people safe. At the time of our inspection new staff had been employed to the service and staff we spoke with felt the service had turned a corner and that staffing had improved.

Medicines were safely managed following seven errors over the past year. This had mainly occurred due to the previous staff shortages and high level of agency staff used to provide care. However, the service had now recruited enough staff and the use of agency staff had greatly reduced and extra training and evaluation had been put in place to reduce further risks.

Staff had the skills and qualities to deliver effective care. However, not all staff felt supported by supervisions as due to staffing shortages in the past these had fallen behind for some staff. Plans were in place to ensure staff received regular supervision and support following the new recruitment of staff.

Staff sought consent from people before providing care and support. However further work was required for ensuring any best interest decision and consent were recorded in line with legislation.

There were plans in place for foreseeable emergencies. Risks concerned with people’s health care and the environment were assessed and reduced as far as was practicable.

Staff contacted healthcare professionals when they had concerns about people’s health and wellbeing.

People were treated with kindness and compassion. Staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times.

People were supported with their nutritional needs when required. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes.

There were systems in place to monitor the quality and safety of the service provided. Staff felt supported by the new manager.

SeeAbility - Meadowmead Support Services met the characteristics of Good in some areas and of Requires Improvement in others. Overall, we have rated the service as Required Improvement.

More information is in the full report below.

Rating at last inspection: At the last inspection the service was rated as Good. (Report published 30 January 2018).

Why we inspected: This was a scheduled inspection that was bought forward due to information received about risks in the service.

Follow up: We will follow up on this inspection as per our re-inspection programme, and through ongoing monitoring of information received about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be available in the office.

SeeAbility - Meadowmead Support Services provides personal care and support to people in their own homes. At the time of our inspection the agency was providing a service for seven people with a variety of care needs, including people living with sight loss and learning disabilities. Some people had very limited verbal communication skills. The agency was managed from a centrally located office base in Eastleigh.

The home had a registered manager. 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.

Staff sought consent from people before providing care and support. However further work was required for a best interest decision.

People felt safe with the service provided by SeeAbility - Meadowmead Support Services and risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies.

Relevant recruitment checks were conducted before staff started working at SeeAbility - Meadowmead Support services to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.

People were supported to take their medicines safely from suitably trained staff. Medication administration records (MAR) confirmed people had received their medicines as prescribed.

People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and went out of their way to provide people with what they wanted.

Staff received regular support and one to one sessions or supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role.

People were cared for with kindness and compassion. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a range of activities. Staff knew what was important to people and encouraged them to be as independent as possible.

A complaints procedure was in place. There were appropriate management arrangements in place. Regular audits of the service were carried out to assess and monitor the quality of the service.

We spoke to three staff members. They told us they felt that they could approach colleagues for guidance and support with their roles.

We found people's independence and involvement was promoted. People's needs and wishes were recorded in support plans.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw that appropriate checks had been undertaken before people began work at the agency to ensure that only appropriate people were employed.

We found that there were not sufficient numbers of staff employed by the agency to safeguard the health, safety and welfare of the people who used them.

We saw evidence of action taken by the manager to address concerns raised by people. This demonstrated that people were listened to and appropriate action was taken.

Records showed that documentation was not always completed as intended or reviewed regularly meant that they may not describe the current needs of the people that used the agency.

People's needs were accurately assessed and care was delivered in line with their support plan. The service had policies and procedures in place to control the risk of spread of infection. These were understood and followed by staff. Staff also followed medication policies and procedures. This helped them to support people to manage their prescribed medicines safely.

Staff were well supported by management and were provided with appropriate training to help them to understand and meet the needs of people who used the service. There was an effective system in place to monitor the quality of the service and changes were made to improve the service if any shortfalls were found.