You are here

Physical Disabilities Outreach Support Services Bramshurst Good

Reports


Inspection carried out on 18 December 2017

During a routine inspection

The inspection took place on 18 December 2017 and was announced. At the last inspection on 27 August 2015 we rated the service Good. At this inspection on the 18 December 2017, we found the service remained Good.

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 pla

Inspection carried out on 27 August 2015

During a routine inspection

We carried out an announced inspection on the 27 August 2015. The last inspection of this service was carried out on 16 September 2014 and all the standards we inspected were met.

The Physical Disabilities Outreach Support Service Bramhurst, operates a domiciliary care support service from this location and provides assistance to four people with a range of physical disabilities and varying support needs in their own flats.

The service had a registered manager in place. 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 were suitable arrangements in place to safeguard people including procedures to follow and how to report and record information. A whistleblowing procedure was in place.

Risk assessments had been completed, recently reviewed and updated for people using the service. They included risk assessments for moving and handling, medicine management and any other risks identified for an individual.

There were sufficient numbers of suitable staff to meet people’s needs and keep them safe. People’s dependency needs were kept under continuous review to ensure that staff had the necessary skills, abilities and experience to provide appropriate care and support.

People were involved as much as possible in taking their medicines independently and risk assessments were in place to indicate the steps to take to ensure safe and proper administration of medicines.

Staff were supported to develop their skills so they could continue to meet people's needs and had undertaken specialist training in specific areas.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to support people who lacked the mental capacity in line with the principles of the act and particularly around decision making.

Staff we were aware of the nutritional needs of people who they supported and the need to follow instructions for people with regard to health issues such as soft diets and cultural preferences.

People were registered with a local GP and staff supported people to access health services and appointments to ensure they were able to maintain good health.

Staff understood the importance of maintaining confidentiality and privacy and we saw evidence of this during our visit. They attended equality and diversity training and policies and procedures were in place for them to refer to for guidance.

People's needs were assessed and support was planned and delivered in line with their individual support plan. When people’s needs changed, it was quickly identified and prompt, appropriate action was taken to ensure people’s wellbeing was protected.

There were systems in place for addressing any complaints and ensuring feedback was given to the complainant. There were no complaints recorded and no accidents or incidents.

The staff team were committed to ensuring the service provided supported people to achieve the outcomes and goals expected and for support to be delivered in a person centred way.

The registered manager was supportive and staff received regular guidance through supervision, team meetings and they said that he always made himself available to speak to.

Processes were in place to ensure the delivery of a high quality service. Care records were checked every week by the registered manager and the senior support coordinator, any issues and concerns were identified and actions put in place to address them.

Inspection carried out on 16 September 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

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.�