Physical Disabilities Outreach Support Services Bramshurst

The Physical Disabilities Outreach Support Service Bramhurst, provided a domiciliary care support service from the location and assistance to people with a range of physical disabilities and varying support needs in their own flats at the location. Due to the budget re-evaluation by the provider, the service was scheduled to close down in March 2018. At the time of our inspection, the service was providing care to three people. The service was in the process of finding the most appropriate accommodation for all three individuals that would be in line with their needs and their individual preferences.

Although the provider had made the decision about closing the service the registered manager and the remaining staff team continued to provide good quality of care to people who used the service. There were many good things about the service. It provided care to people with complex needs and behaviour that often challenged the service. We found that there was very positive and trusting relationship between staff and people. People spoke positively about the support they received and staff appeared compassionate and caring towards people.

Staff supported people to take their medicines and the registered manager took appropriate action to address any gaps in medicines management by staff.

People were safe at the service. The risk to people’s health and wellbeing were assessed and managed and accidents and incidents were reported. There were appropriate infection control measures put in place and people were protected from unnecessary infection .Safe recruitment procedures ensured that people were supported by staff that were appropriately vetted. There were sufficient staff deployed to ensure people’s need were met.

People were appropriately assessed and their needs had been discussed before they started receiving support from the service. People were happy with the support they received and they thought staff had the knowledge, skills and experience to support them effectively.

Each person had been receiving the support from the service for at least four years. Staff working at the service were employed there for at least two years. Staff and people told us they knew each other well..

Staff received regular training that the provider considered mandatory. Staff said the registered manager supported them through regular supervision, staff team meetings and working alongside them.

Staff had good knowledge about people dietary needs and preferences and people received appropriate support in relation to their food and drink intake. Staff also supported people to have access to appropriate health professionals and staff worked together and with other health professionals to ensure people received required medical attention.

The service followed the principles of the Mental Capacity Act 2005 (MCA). People’s capacity was assessed by respective professionals if required and there was evidence that people gave their written consent do care and support provided by the service.

People were supported by staff who cared for them, were compassionate and were respectful and responsive to their needs. Staff encouraged people to build on their confidence and life skills.

Staff met with people for regular one to one keywork meetings in which people were encouraged to discuss various elements of their care and decide how they would like their support to be provided. When requested by people staff supported them in following their interests and doing things they liked.

People’s dignity and privacy was respected and when providing personal care staff ensured this was done in a respectful way and how people preferred it.

People received care that was bespoke and in line with people’s needs and preferences. People’s care plans were person centred and gave staff sufficient information on how to support people safely and effectively.

People had access to the provider’s complaints procedure and staff offered their support if people wanted to make a formal complaint about the support they received from the provider or any other service.

There were monitoring systems in place that helped the registered manager to monitor various aspects of the service and to ensure that people received support that was safe and effective and in line with their needs and preferences.

The registered manager and the staff team received positive feedback from external health professionals, who thought staff had positive relationship with people, encouraged them to undertake treatment and accept the support that they had previously refused.

We saw that the service had appropriate policies and procedures in place to guide staff on various areas related to their work and their professional roles.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary describes what people using the service, their representatives and the staff told us, and the records we looked at. There were four people using the service at the time of our inspection. We spoke with two people who used the service, two care workers and a service manager. We also spoke with a physiotherapist and an occupational therapist employed by the NHS and two local authority social workers. We looked at four care records of those who used the service.

Is the service safe?

One person who used the service told us 'I definitely feel very safe.' Staff were available to be contacted at all times in cases of emergency. The provider ensured their staff had the skills and experience needed to support those who used the service. Care workers were trained in safeguarding awareness and demonstrated their knowledge of this to us. They also had an understanding of the Mental Capacity Act 2005 and how it applied to those who used the service.

Is the service effective?

We spoke to those who used the service and were told they were happy with the care provided. One told us 'staff make suggestions, which usually make the outcome better for me.' Staff told us they understood people's care and support needs and said they referred to the support plan at all times. We read one comment from a social worker, which stated 'thank you for all the support you have given my client and for keeping me in the loop.' Staff had received training to meet the needs of the people whom they supported. One person told us 'staff go on training, they are very professional.'

Is the service caring?

We were told how respect for the dignity of the person was observed and how permission was sought before any personal care was given. Care plans were developed to meet identified needs which were reviewed every three months. One person who used the service told us 'the staff do everything they should do, and go beyond that when I need it.' It was clear from speaking with staff they understood people's care and support needs and how to deliver them. We observed how care workers were patient and gave encouragement when supporting people. They responded quickly to calls for support.

Is the service responsive?

People's needs had been assessed and support was offered to meet those identified needs. A local authority social worker told us 'care workers have already made suggestions about how they could work differently with a particular service user.' A psychologist told us 'staff use support offered by other services and always seem to value professional advice given.' Records confirmed people's diverse needs and care and support had been provided which met their wishes.

Is the service well-led?

Staff had a good understanding of the philosophy of the service. They told us they were clear about their roles and responsibilities. Quality assurance processes were in place, tailored to the service provision. A service manager told us 'the registered manager is very hands on.' A psychologist told us 'the manager's involvement with the service makes it very easy for our team to work service users there.'