Sunrise Care Domiciliary Agency

Sunrise Domiciliary Care Agency is a small supported living service that provides support to people with learning disabilities and other cognitive impairments. At the time of our inspection the service was supporting six people living in a shared house.

This service provides care and support to people living in one ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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 choice, control and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People told us they were happy with the support that they received. They spoke positively about staff.

Care and support was person centred and reflected people’s individual needs. People’s support plans and risk assessments were person centred. They had been reviewed regularly and updated when there were any changes in people’s needs.

Staff were knowledgeable about people’s needs and preferences. People told us that staff had supported them to achieve greater independence.

Staff had received training in safeguarding adults. They understood their roles and responsibilities in ensuring that people were kept safe from harm or abuse.

People were supported to make decisions about their support. People told us that they participated in meetings about their needs and were involved in developing and agreeing their support plans.

The service was meeting the requirements of the Mental Capacity Act (2005). Information about people’s capacity to make decisions had been recorded in their care files.

The support provided by staff was person centred. Guidance for staff was included in support plans and risk assessments to ensure that they understood people’s needs and preferences, People’s support plans and risk assessments had been reviewed regularly and updated where there were changes in their needs.

Staff communicated well with people. They spoke with people about subjects of interest and checked that people understood information and requests.

Staff had received training in a range of core skills and this was updated regularly. Newly recruited staff members did not commence work until checks on their suitability had been carried out. Regular supervision from a manager had taken place to support staff to carry out their roles and responsibilities effectively.

Staff supported people to take their prescribed medicines safely. Accurate records of medicines administration had been completed.

People planned and shopped for their food independently or with staff support where required. Staff supported people to cook and prepare meals where required. A person described how they shopped independently for food that meet their cultural and religious preferences.

People had good healthcare support. Staff had supported people to attend healthcare appointments. Where health or other professionals had provided guidance in relation to people’s needs this was included in their support plans.

Regular quality assurance monitoring of the service had taken place and any actions arising from this had been addressed. Some actions had not been dated although we found that they had been completed.

People had been asked about their views of the service. We found that people demonstrated a high level of satisfaction with the support that they received.

Rating at last inspection:

The service was rated Good (Report published 19 October 2016).

Why we inspected:

This was a planned inspection based on our rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme.

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

The provider met all the standards we inspected against at our last inspection on 28 October 2013.

There was a registered manager in post at the time of our 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.

During the inspection we observed people were treated with kindness and compassion. It was evident that positive caring relationships had developed between people who used the service and staff. People who used the service spoke positively about staff and the care provided at the service.

Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and staff were aware of potential risks to people and how to protect people from harm. Staff were knowledgeable about people’s individual care needs and were aware of the triggers and warning signs which indicated when people were upset and how to support people appropriately.

On the day of the inspection we observed that staff did not appear to be rushed and were able to complete their tasks. People who used the service told us that staff always had time to speak with them. The registered manager explained that there was flexibility in respect of staffing and staffing levels were regularly reviewed depending on people's needs and occupancy levels.

There were arrangements for the recording of medicines received into the service and for their storage, administration and disposal. People told us that they received the medicines on time and had no concerns regarding this.

We found the premises were clean and tidy. There was a record of essential inspections and maintenance carried out. The service had an Infection control policy and measures were in place for infection control.

Care support workers demonstrated that they had the knowledge and skills they needed to perform their roles. Staff confirmed that they received regular supervision sessions and appraisals to discuss their individual progress and development. Care support workers spoke positively about the training they had received and we saw evidence that staff had completed training which included safeguarding, medicine administration, health and safety, first aid and moving and handling.

People’s health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people’s likes and dislikes. People told us that they received care, support and treatment when they required it. Care plans were reviewed regularly and were updated when people’s needs changed. The registered manager explained to us that they encouraged people to be independent as much as possible but provided support where necessary.

All care support workers we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). People in the serivce all had capacity to make their own decisions and care plans demonstrated that they were involved in making decisions about their care.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. The registered manager informed us that none of the people who lived in the service were subject to any orders depriving them of their liberty. We noted that people could freely go out when they wanted to.

People spoke positively about the food arrangements in the service. There was not a set menu as people ate what they liked and when they liked. The registered manager explained that there was flexibility in respect of what people wanted to eat. People’s weights were recorded regularly. This enabled the service to monitor people’s nutrition so that staff were alerted to any significant changes that could indicate a health concern related to nutrition.

People spoke positively about the atmosphere in the service and we observed that the service had a homely atmosphere. Bedrooms had been personalised with people’s belongings to assist people to feel comfortable.

People told us that there were sufficient activities available. Activities included attending the local day centre, working and going shopping.

We found the service had a management structure in place with a team of care support workers and the registered manager. The service had an open and transparent culture. Care support workers told us they were encouraged to have their say and were supported to improve their practice. They told us that the morale within the service was good and that all care support workers worked well with one another.

Staff were informed of changes occurring within the service through staff meetings and we saw that these meetings occurred regularly and were documented. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

There was a quality assurance policy which provided detailed information on the systems in place for the provider to obtain feedback about the care provided at the service. The service undertook a range of checks and audits of the quality of the service and took action to improve the service as a result.

The agency had a policy on ensuring equality and valuing diversity. Staff were aware that they should treat people with respect and dignity regardless of their diverse backgrounds. People informed us that they felt safe with their carers. Staff had been provided with training on safeguarding people and were aware of action to take when responding to allegations or incidents of abuse.

People had been assessed prior to care being provided. Risk assessments and care plans were in place. There was evidence that people had been consulted regarding their care. Staff were aware of the needs of people and able to provide the agreed care. Records examined indicated that staff had been carefully recruited.

The provider had an effective system to regularly assess and monitor the quality of service that people received. A recent service user survey indicated that people were happy with the quality of services provided.

Care staff we spoke with were aware of the importance of treating people with respect and dignity regardless of their diverse backgrounds. People informed us that they felt safe with their carers. Care staff had been provided with training on safeguarding people and were aware of action to take when responding to allegations or incidents of abuse

The agency had an updated medication policy and the arrangements for the administration of medication were satisfactory. People had been assessed prior to care being provided. Risk assessments and care plans were in place. Staff were aware of the needs of people and able to provide the agreed care. Training records indicated that staff had been provided with essential training to enable them to do their jobs well. Staff said they had been provided with support and formal supervision.