Archived: Independent Living Service - East Yorkshire

At the time of our inspection the service was supporting 13 people with a learning disability or physical disability. People lived in their own bungalow, either individually or sharing with one or two other people. All the bungalows were co-located on the same site in Market Weighton, which is a small market town in East Yorkshire. People lived within walking distance of local shops and community facilities.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen. Although the service supported 13 people on the same site, which is higher than the amount considered best practice by Registering the Right Support, the provider ensured that people had an individually tailored service, a choice of who they lived with and were supported by, plus full access to the local community. Each person's bungalow was personalised to their taste and preferences.

There was a registered manager in post, supported by an acting deputy manager. We received consistently positive feedback about the management and leadership of the service.

Risk assessments were in place to help staff reduce risks to people’s safety and well-being. Staff had received training in safeguarding vulnerable adults and were aware of the action they should take if they had any concerns. Safe systems were in place to ensure people received their medicines as prescribed.

There were sufficient staff to meet people’s needs. The provider conducted appropriate recruitment checks before staff started their employment, to ensure candidates were suitable to work with vulnerable people. Staff received comprehensive training, support and supervision to give them the skills and knowledge they needed for their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff supported people to maintain their health and access healthcare services whenever needed. Care files contained clear information about people’s healthcare needs and people had an annual health check. People were supported to have a healthy, balanced diet and received assistance, where required, with meal planning and food preparation.

Staff promoted people’s independence and helped people maintain and develop their daily living skills, such as cleaning their home and shopping. Staff upheld people’s privacy and dignity.

People told us staff were caring and we observed staff were kind, respectful and enabling in their approach. People’s diverse needs were respected. Staff understood and responded to people's individual communication needs. There was a range of information available to people in easy read or pictorial format.

The provider developed a care and support plan for each person, to give staff the information they needed to support people in line with their needs and preferences. The service had good links with the local community which helped enrich the opportunities available to people. People took part in a variety of different activities and pastimes of their choice.

The provider had a system in place for responding to any concerns and complaints. People told us they would feel comfortable reporting any concerns.

The provider had a quality assurance system in place and we found this was used effectively to monitor the quality of the service and make improvements where required. Our discussions with staff and people indicated there was a positive, person-centred culture within the service and people were satisfied with the support they received.

Further information is in the detailed findings below.

At the time of our inspection, 13 people received a personal care service. The service provides community based care and support services from the registered office location, in Market Weighton.

The registered provider is required to have a registered manager in post and on the day of this inspection, there was a registered manager registered with the CQC. A registered manager is a person who has registered with the CQC 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 who used the service told us they felt safe and we found that care workers had received training in safeguarding adults and knew how to protect people from abuse and avoidable harm. Risk management plans were in place and they were regularly reviewed and updated in line with the person's needs.

People's care files were person centred this meant they focused on the individual. Care plans included an easy read version (easy read refers to the presentation of text in an accessible, easy to understand format) and a section, 'What's Important to Me'. This recorded personal history, personal preferences, interests and aspirations of people. Care workers told us this documentation helped to provide people with holistic person centred care. The registered provider had a system in place to record, investigate and learn from Accidents and incidents. We saw that because of these investigations, the registered provider had implemented risk assessments and had updated peoples support plans.

The registered provider undertook a variety of recruitment checks to help ensure care workers recruited were considered suitable to work with vulnerable people. Once employed, care workers underwent a continuous induction and probationary period where they received appropriate training and competency checks to help meet people’s needs and to check they upheld the basic values of care.

There were enough members of staff to meet people's needs. People and care workers raised concerns around the use of agency staff. The registered manager told us they had an action plan in place to recruit permanent care workers and appropriate checks were carried out when agency staff were used. The registered provider recognised the importance of building relationships between people and the carers and told us they had involved people in the recruitment process. People were assigned a keyworker who acted as a first point of contact for all their needs and documented and updated their care plans and associated records in line with their needs, wishes and preferences.

The registered provider had a medication policy and procedure in place and this followed guidance provided by 'The National Institute for Health and Care Excellence' (NICE). We saw this was reviewed and updated at least annually. There was clear guidance for people who were prescribed 'as and when needed' (P.R.N) medication and appropriate guidance by way of pictorial body maps was documented for the application of patches, creams and emollients.

Care workers had received training and understood the requirements of The Mental Capacity Act 2005 (MCA). Where people’s capacity was deemed in question, the provider liaised with appropriate health professionals in line with the MCA.

The registered provider had appropriate housekeeping, maintenance and inspection programmes in place for the environment, equipment and utilities. These were up to date and helped to ensure the safety of the premises from people, staff and others. We saw people were kept safe from the risk of emergencies in their home. People had a risk assessment in their care files for the environment and a personal emergency evacuation plan (PEEP).

People were supported to maintain good health. Care plans contained detailed information to ensure people were not at risk of malnutrition. We saw peoples dietary requirements noted in their care plans that included details of food likes, including any religious dietary requirements and information on supporting people with good nutrition and hydration.

Care workers told us they felt well supported and understood their roles and responsibilities. They told us they had positive relationships with other health professionals to support people when the need arose.

We received positive feedback about the leadership and there was a high degree of confidence in how the service was run. Care workers we spoke with told us the registered manager was approachable open and honest. Management understood how to meet the conditions of their registration with the CQC.