NAS Community Services (North 2)

NAS Community Services (Lancashire) is registered to provide personal care and support to people on the autistic spectrum who are living in their own homes. This included people living in shared housing as part of a supported living arrangement. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our visit 21 people used the service.

The service was managed by a registered manager. 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.

At our last inspection on 14 and 17 October 2017 the overall rating of the service was ‘Requires Improvement’. There was a breach of regulations relating to staff training and development. We asked the provider to make improvements on these matters. We received an action plan from the provider indicating how and when they would meet the relevant legal requirements. We also made a recommendation on improving quality monitoring systems. At this inspection we found sufficient improvements had been made.

We found there were management and leadership arrangements in place to support the effective day to day running of the service.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service. Systems were in place to ensure staff received ongoing training/learning and supervision.

There were sufficient numbers of staff at the service. Support was provided in response to people’s agreed plan of care. The use of agency staff was being monitored and kept under review.

Risks to people’s well-being were being assessed and managed. Systems were in place to support people in maintaining a safe and clean home environment.

Processes were in place to support people with their medicines. We found some matters needed improvement; however these were put right during the inspection. Checks were carried out to identify medicine errors and make improvements.

Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff said they had received training on safeguarding and protection matters. They had also received training on positively responding to people’s behaviours.

We observed positive and respectful interactions between people using the service and staff. People made positive comments about the staff team.

Arrangements were in place to gather information on people’s backgrounds, their needs, abilities, preferences and routines before they used the service.

Each person had detailed care records, describing their individual needs, preferences and routines. This provided clear guidance for staff on how to provide support. People’s needs and choices were kept under review and changes were responded to.

Staff expressed a practical awareness of promoting people’s dignity, rights and choices. People were supported to engage in meaningful activities at their homes and in the community. Beneficial relationships with relatives and other people were supported.

Processes were in place to support people with any concerns or complaints. There was an ‘easy read’ complaints procedure for people, which provided guidance on making a complaint.

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

People were encouraged to lead healthy lifestyles. They were supported with their healthcare needs and medical appointments. Changes in people’s health and well-being were monitored and responded to.

People’s individual dietary needs, likes and dislikes were known and catered for. Arrangements were in place to help make sure people were offered a balanced diet and healthy eating was encouraged.

There were systems in place to consult with people who used the service, relatives and staff, to assess and monitor the quality of their experiences and make improvements.

NAS Community Services (Lancashire) is a supported living service that provides care and support to people on the autistic spectrum living in their own homes. At the time of the inspection there were 20 people using the service.

The service was managed by a registered manager. 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.

This was the first inspection of this service. During the inspection we found there was one breach of the current regulations. This related to the management of staff training. You can see what action we told the provider to take at the back of the full version of the report. We also made a recommendation about the analysis and evaluation of all information gathered as part of the quality assurance processes.

People using the service said they felt safe and staff treated them well. Appropriate recruitment checks took place before staff started work. There were enough staff on duty and deployed throughout the service to meet people's care and support needs. Safeguarding adults’ procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People's medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Arrangements were in place to provide staff with training, however, we noted from talking to staff and looking at the training matrix that not all staff had received refresher training. New staff completed an induction programme which included the Care Certificate.

The registered manager and staff understood the principles associated with the Mental Capacity Act 2005 (MCA) and acted according to this legislation. There were appropriate arrangements in place to ensure people were supported to follow a healthy diet. People had access to a GP and other health care professionals when they needed them. People were supported to participate in activities that were personalised and meaningful to them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. We observed staff had a good relationship with people and supported them in an attentive and caring manner. Where possible, people using the service had been consulted about their care and support needs. Support plans and risk assessments provided guidance for staff on how to meet people’s needs. However, we noted one person’s risk assessments were not available in their house. We found the assessments had been taken to the office for the registered manager to read and sign. We were assured by the registered manager a new system would be implemented to ensure staff had access to the information at all times.

People were aware of how they could raise a complaint or concern if they needed to and had access to an easy read complaints procedure.

There were systems in place to monitor the quality of the service which included seeking feedback from people using the service and regular audits. However, we noted the information gathered during the quality assurance process was not always analysed and evaluated in order to identify any trends and address any issues raised.