This inspection took place on 21 and 22 March 2017 and was announced.
The previous inspection was carried out on 29 October 2015 and was rated as requires improvement. Recommendations were made that care plans and risk assessments should be reviewed on a regular basis and that the registered provider should seek advice and guidance on a suitable audit system. An action plan was received which showed that improvements would be made. At this inspection we saw that relevant improvements had been made.
Deafness Support Network (DSN) provides personal care and support to people who are D/deaf. The support is carried out in their own homes. The agency provides support for up to twenty-four adults who are D/deaf and may have dual sensory impairment; learning disability; physical disability or mental health problems. The office is situated in the suburbs of Northwich, near to all the town's amenities and within easy access to main road networks. People live within one of four houses which are situated near to the office. At the time of our inspection there were 23 people using the service.
The word Deaf (with a capital D) is used to denote an individual whose first language is British Sign Language (BSL), whilst the term D/deaf is widely recognised by service professionals and refers to everyone with a hearing loss which includes Deaf, deafened and hard of hearing. D/deaf will be used throughout this report.
There was a registered manager employed to work at the service. They had been registered with the Care Quality Commission for six years. 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 the previous inspection on 29 October 2015 we made two recommendations: that the registered manager ensured that care plans and risk assessment documentation should be reviewed to ensure they are kept up to date and accurate; and that the service sought advice and guidance from a reputable source about a suitable audit system for the service. We saw that improvements had been made and that care plans and risk assessments were clear and up to date and a new audit system was in place.
People told us they were happy with the service provided and that the staff were caring, kind and friendly. People said “The staff are good”, “I have no complaints” and “Staff are kind.”
Staff told us they enjoyed working at the service and providing support to people. They said they were supported by the team leaders and registered manager.
Care plans were person centred, well documented and up to date. They gave clear guidance to the staff team. Risk assessments were undertaken for a variety of tasks and these were reviewed regularly and up to date. The management of medication was safe.
Staff were aware of how to report a safeguarding concern. They were aware of the policies and procedures available to safeguard people from harm and told us they would not hesitate to report any concerns.
Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). Care records demonstrated people's involvement in decision making. Mental capacity assessments were completed and best interest meetings took place when needed.
Staff had received a range of training that included moving and handling, safeguarding, medication and health, safety and fire. All staff had either to use British Sign Language as their first language or have attained BSL level 2 within two years of employment. A range of other training was available to the staff team. Staff told us that the training was good. Staff had access to supervision sessions, annual appraisals and were invited to attend regular staff meetings.
Staff recruitment files showed that robust recruitment processes were in place. Staff attended an induction process and staff told us that they worked alongside an experienced staff member to get to know the roles requirements. They confirmed the induction process was good and that they had the information they needed to perform their role.
People had access to information about the service. Some people said that they knew the information was in their care folder and some people had read this or had the information signed to them by the staff.
A complaints policy was available and each person had this information within the care folder. Processes were in place to deal with any complaints received.
Quality assurance processes were in place to ensure that support standards were being maintained and reviews of people’s care were undertaken. Audits were undertaken in relation to the service provided and these monitored the services safety and effectiveness.