Archived: Enfield Adult Placement Scheme

Enfield Adult Placement Scheme arranges for vulnerable people to live with adult placement carers either on a permanent or short term respite basis. People who use the service may have learning/physical disabilities, mental health needs, older people or young people leaving care. On the day of the inspection there were 15 people using the service.

The service had a registered manager in place at the time of the inspection. 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 and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look out for and how to raise safeguarding concerns.

Detailed current risk assessments were in place for people using the service. Risk assessments in place were reviewed and updated regularly. The risk assessments explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person. People were supported to take positive risks.

Medicines were managed safely and effectively and there were regular medication audits in place. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff. Risk assessments specific to medicines were in place for people who were supported to take medicines.

The service maintained sufficient staffing levels and when carers were unable to provide care or took leave, the registered manager ensured care was provided to people with the minimum disruption.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. People lived with the carers in their own homes and excellent comments were received from people, relatives and carers were in relation to the person being part of the carer’s family and having long term relationships. Carers and staff consistently went the extra mile to ensure people led independent and fulfilling lives.

Care plans were person centred and reflected what was important to the person. Care needs are regularly reviewed and updated to meet the changing needs of people who use the service.

We saw evidence of a comprehensive staff induction and ongoing training programme. Staff were also safely recruited with necessary pre-employment checks carried out. Staff had regular supervisions and annual appraisals.

All staff had received training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and staff understood what to do if they had concerns as regards people’s mental capacity. These safeguards are there to make sure that people are receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

People are supported to maintain good health and have access to healthcare services. Referrals are made quickly when concerns are noted as regards people’s health.

Staff regularly met with people and their carers to ensure the service was meeting their needs and they were providing a good service.

The service regularly requested feedback from people who use the service. People also attended service user forums where they had an opportunity to meet other people who use the service, celebrate achievements and feedback on their experiences of using the adult placement scheme.

There was a complaints procedure in place which was displayed for people and relatives. Complaints were logged and monitored for trends and learning points identified were actioned. There was an incident and accident procedure in place which staff knew and understood. There was evidence of audits as regards medication and overall compliance. Issues identified were actioned promptly.

The registered manager enabled an open culture that encouraged staff and people to discuss issues and ideas, though team meetings and service user forums. Adult Placement Officers supported care staff on a daily basis.

The registered manager continually seeked to improve the service and implemented an action plan which identified areas for improvement and actions were put in place accordingly.

People who used the service had been carefully assessed by the placement service to ensure that they were suitably matched with their adult placement carers. Individual risk assessments were in place. Care plans had been prepared with the involvement of people who used the service and their representatives. The care provided was closely monitored by adult placement officers and the registered manager.

There were suitable arrangements for the administration of medication. With the exception of those who self-medicate, people informed us that their medication had been administered to them by their carers.

The service had a recruitment procedure and policy. There was evidence that staff had been carefully recruited. The recruitment records contained references, criminal records disclosures, evidence of identity and other essential documentation.

The service had an appropriate complaints procedure and records examined indicated that complaints made had been promptly responded to.

Each person had a support plan which described their care needs, and demonstrated that people had been consulted about their needs and preferences. Records confirmed that each person had a health action plan, and they were able to see medical professionals when necessary.

People told us that they felt safe with the carers who supported them. They told us they had no concerns about the service but felt able to talk to their carer or scheme staff if they needed to.

Carers told us they felt supported by the scheme's staff and confirmed they received regular supervision and appropriate training.

People who use the service confirmed that staff at the scheme visited them on a regular basis and asked them how things were going and if they were satisfied with the care and support they received.