Archived: Grace Eyre- Choices, Sussex

The Grace Eyre Foundation provides supports people who have a learning disability and/or a mental health need, through shared lives services, day care, housing and domiciliary support.

Grace Eyre Choices Sussex is a domiciliary care agency and provides personal care and support for adults with a learning disability living in their own home and in supported living accommodation in the Brighton and Hove and West Sussex area. At the time of our inspection around 155 people were receiving a service. The staff team help people to develop independent living skills. They can help with people learning to cook, budgeting, managing medication, personal care, accessing the community and aim to promote healthy lifestyles. Not all the people received the regulated activity of personal care.

On the day of our inspection, there was 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.

There was a clear management structure with identified leadership roles. The registered manager was supported by a quality manager, five service managers and two team leaders each covering a geographic area, or a supported living service. The registered manager supervised the service managers and then supervised the team leaders in a geographic area. The service managers visited new people who wished to receive a service, undertook the monitoring visits and reviews and managed the team leaders and care staff within a geographic area. The team leaders managed a supported living site, undertook the monitoring visits and reviews and managed the care staff. One member of staff told us, “We talk and support each other. We come up with better decisions. We use each other’s strengths.”

The organisation was outstanding in the way they strove to ensure the service was ‘service user led.’ There were a range of forums and accessible information to support and enable people to give their views on the care and support provided, and to be actively part of the development and running of the service. People were listened to and encouraged to give their views, which were taken into account and used to shape the service. One member of staff told us, “The way they work with service users, they are included in everything. They are part of the staff interviews, and they are looking at having service users on the board. The company puts people first. It’s about supporting people not the finances.” Another member of staff told us, “We are light, open and transparent. We all make mistakes. It’s a person centred approach. It’s really trying to support customers to have a say in how the service will go and get as user led as possible. It’s just been improving and improving.”

People were supported by extremely kind and caring staff. One relative told us, “We are encourage their hearts are in the right place. It’s heart-warming.” Care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence. One member of staff told us, “The client is our main focus, and we support them to achieve what they want from life. They are the most important part of the job.” One person told us they were,” Quite happy with everything.” People’s care and support plans were detailed and reviewed regularly. Detailed risk assessments were in place to ensure people were safe within their own home and when they should receive care and support.

People told us they felt safe in the service. People were supported by care workers who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. One member of staff told us, “There is always good training opportunities. “There were systems in place that ensured this knowledge was checked and updated. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.

People were supported to eat a healthy and nutritious diet. People had access to health care professionals and had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. Medicines were managed safely and people received the support they required from care staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

There was a detailed complaints procedure. The registered manager told us that they operated an 'open door policy' so people, their representatives could discuss any concerns. The office was based alongside in the same building as other of the providers services such as the day care service. People were encouraged to come and talk with staff in the office about the service and any concerns they had when they were visiting the building. We observed a lot of interacts between people and the staff throughout the day during our visit. One member of staff told us, “We have an open office policy. This has worked really well. They can come up and have a chat to us.”

The registered manager, along with the quality manager, service managers and team leaders provided good leadership and support to the care staff. One member of staff told us, “Our team is great. I like coming to work. We work hard, but we do a good job.” Another member of staff told us, “The person you support is always at the centre of the care.” Another member of staff told us, “I feel supported. I can find someone to discuss things straight away. It’s a good place to be, and gives us opportunities to develop and work is varied.” Care staff told us communication was good in the service. One member of staff told us, “I communicate by email and get a fast response.” Systems were in place to audit and quality assure the care provided. People were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care, forums, and they were asked to complete a satisfaction questionnaire to help identify any areas for improvement. There was evidence as to how any feedback was acted upon and improvements made to the service provided.

During our inspection we spoke with four people who used the service as well as seven members of staff. We spoke with the deputy chief executive and regional manager, the registered manager, three support workers and a service user involvement worker. We also looked at surveys and meeting records to help us understand the views of the people who used the service.

One person who used the service told us 'they provide a very good service and everyone is helpful' another person told us 'my support workers help me with anything I need, I like them a lot'.

The staff we spoke with felt they all worked together as a team and enjoyed working at Grace Eyre. One member of staff told us 'this is a challenging but rewarding place to work, I feel listened to and supported when needed'. Another staff member told us 'I love the vision of the organisation, we all work well as a team and support one another'.

We also looked a paper based and electronic care plans, risk assessments, staff records and policies and procedures.

This told us before people had received any care or treatment they had been asked for their consent and the organisation's staff had acted in accordance with their wishes. People or their representatives had been involved in making decisions about their care and treatment.

People's care needs had been assessed and reviewed, and care and treatment had been planned and delivered in line with their individual care plan.

People's care had been provided by support workers who understood their care needs and who had been provided with training and support. One care worker told us 'The training has been so helpful'.

Robust recruitment practices had been followed. Appropriate identity and security checks had been completed as part of the recruitment process.

The records needed for the management of the service had been maintained and were accurate and complete.