Pro Support

Pro Support is a care and support provider for people with mental health needs. The company is registered with the Care Quality Commission (CQC) as a domiciliary care agency as it provides support to people living in their own homes and also in supported accommodation.

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. At the time of inspection, 22 people used the service, however, only one person received personal care and were included in the inspection.

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

We found aspects of one supported living setting was not well maintained. We brought this to the provider’s attention who immediately took action to reduce potential risks and ensure the issues were rectified.

There were quality assurance systems in place based on a range of audits. However, we found these needed to include more detail to enable them to be effective. They had not identified all the concerns identified in this inspection.

Care plans and risk assessments were in place for one person supported by the service. One person told us they found staff caring and kind.

Staff understood the importance of safeguarding people they supported, and they knew how to report any signs of abuse, or any accidents and incidents.

There were enough staff available to support people. Safe recruitment procedures were in place to help ensure only suitable staff were employed.

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

Rating at last inspection and update

The last rating for this service was good (published 6 December 2019).

Why we inspected

We carried out a focused inspection of this service, due to receiving concerns about the support a person received. This report only covers our findings in relation to the key questions Safe and Well-Led. Due to having insufficient evidence we have not rated the service on this occasion.

We have found evidence that the provider needs to make improvements.

Please see the safe and well-led sections of this full report.

Recommendations

We have made two recommendations about implementing safe infection control procedures and undertaking a review their governance and quality assurance processes.

Follow up

Due to having insufficient evidence we have not rated the service on this occasion.

Pro Support is a care and support provider for people with mental health problems, learning disabilities and those with a dual diagnosis. The company is registered with the Care Quality Commission (CQC) as a domiciliary care agency as it provides support to people living in their own homes and also in supported accommodation.

People’s experience of using this service:

People told us they felt safe using the service and staff displayed good knowledge about how to protect people from the risk of harm. People told us they received their medicines as prescribed and staff were recruited safely, with appropriate checks carried out before their employment commenced.

There were enough staff to care for people safely, with staff and people using the service telling us current staffing arrangements were sufficient. Accidents and incidents were monitored and any actions taken to prevent future re-occurrence were recorded.

People received the support they needed to eat and drink. People said they felt treated with dignity and respect and staff promoted their independence as required.

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.

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.

Complaints were handled appropriately, although none had been received since our last inspection. A number of compliments were also made about the service. People were able to access the community independently and spend their time how they wished. Activities and social gatherings were also held at some of the supported houses.

Audits and quality assurance systems were in place to monitor the quality of service. We received positive feedback from everybody we spoke with about management and leadership within the service.

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

Rating at last inspection:

This last inspection was in March 2017 (published April 2017) and the overall rating was Good.

Why we inspected:

This was a routine comprehensive inspection and in line with our timescales for Good rated services which is approximately 30 months from the publication date of the last report.

Follow up:

We will continue to monitor information and intelligence we receive about the service to ensure good quality care is provided to people. We will return to re-inspect in line with our inspection timescales for Good rated services, however if any information of concern is received, we may inspect sooner.

We inspected Pro Support on 1 and 2 March 2017. We announced the inspection two days beforehand to make sure the registered manager would be available at the office and so that the people using the service would know we were coming.

At the last comprehensive inspection of Pro Support Ltd on 7 and 8 October 2015 we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA). We issued the provider with five requirements stating they must take action to address these breaches.

People using the service were either supported in one of four shared houses in the Gorton, Salford and Rochdale areas where they have their own tenancy or in their own homes. The registered manager of Pro Support Ltd is also the landlord to the four shared houses. At the time of the inspection the service was supporting 12 people with tenancies in the four shared houses.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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.

At the last inspection we found that fire safety checks were not carried out properly. At this inspection we found the registered manager had a clear overview for all four tenancies and we found required checks such as fire extinguishers and smoke alarms had been completed in a timely manner.

At the last inspection we found issues with the way medicines were managed for people receiving support with their medicines. At this inspection we found there were now clear protocols in place to tell staff when people could take ‘as required’ medicines safely and medicines administration records were completed correctly.

We found behavioural risk assessments had improved and now contained sufficient detail for staff to understand and manage people’s behaviours that may challenge others.

There were a number of processes in place to monitor the quality and safety of the service. The systems in place to assess and monitor the quality of service provided were effective to ensure care provided was monitored, and that risks were managed safely.

People told us they felt safe at both of the houses we inspected. Staff could explain the different forms of abuse people may be vulnerable to and said they would report any concerns to the registered manager.

The recruitment process the service used was robust. This helped to ensure only those applicants suitable for employment were offered work within the service.

The staff we spoke with had a good understanding of the Mental Health Act 1983 and Mental Capacity Act 2005 and were aware of which people receiving a service had restrictions in place. We also noted that care plans had been developed to ensure people under any restrictions were being assessed and supported in line with their care plan.

There were enough staff to support people according to their care packages and the service could be flexible when people had appointments or needed transport.

Staff told us they felt supported by the manager and that training opportunities were good.

We saw people had access to a range of healthcare services and there was an effective system in place to remind and support people to attend their healthcare appointments.

People were supported to shop for and cook healthy meals and were encouraged to cook for others in the house where they lived.

People and their relatives told us they thought the staff were caring and that they promoted people’s dignity and privacy. We observed interactions between people and staff that were relaxed and friendly.

People were involved in planning and evaluating their care. We saw examples of when people had requested changes to their support and the service had made this happen.

People had access to and described using advocacy services. We saw that this was documented in people’s care files.

People using the service and their relatives told us that if they had any concerns or complaints they would feel able to take these up with the registered manager.

People, their relatives and the support staff were in regular contact with the registered manager and operational manager and felt that they could get in touch at any time.

Incidents and accidents were recorded monitored and investigated. This demonstrated that the provider learned from such incidents and took action to minimise the risk of them happening again.

Team meetings were held regularly and staff were empowered to take ownership of the meeting content and use them as opportunities for professional development.