We carried out an announced inspection of the service on 24 March 2016. Reach Learning Disability Care Ltd (RLDC) is registered to support people with their personal care. RLDC specialises in providing care and support for people who live with a learning disability, in their own homes and when out in the community. At the time of the inspection there were thirty eight people receiving support with their personal care.
On the day of our inspection there was not a registered manager in place, although an application for them to become registered had been received. 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.
The risk to people’s safety was reduced because staff could identify the different types of abuse, knew how to report concerns and had attended safeguarding adults training. However some staff required refresher training.
Risk assessments had been completed in areas where people’s safety could be at risk. People had the freedom to live their lives as they wanted to. Staff, including volunteers, were recruited in a safe way. People told us there were enough staff to meet their needs and to keep them safe.
Accidents and incidents were investigated. Assessments of the risks associated with the environment which people lived were carried out and people had personal emergency evacuation plans (PEEPs) in place. Processes were in place to ensure people’s medicines were stored, handled and administered safely, although the reasons ‘as needed’ medicines were administered were not always recorded.
People were supported by staff who received an induction, although when staff had commenced the Care Certificate training their progress had not always been reviewed. Staff received training, although there were some areas where staff required refresher training. Staff received regular assessment of the quality of their work, although during 2015, these assessments were limited.
The registered manager ensured the principles of the Mental Capacity Act 2005 (MCA) had been applied when decisions had been made for people. Staff ensured people were given choices about their support needs and day to day life. The registered manager was aware of the requirements to apply for and implement Deprivation of Liberty Safeguards (DoLS) if applicable. However, we did find one example where a lap belt was used to secure a person in their wheelchair and the relevant DoLS application had not been made.
People were encouraged to plan, buy and cook their own food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.
People were supported by staff who were kind and caring and treated them with respect and dignity. People were able to contribute to decisions about their care and support needs, although examples of this in people’s records was limited. People were provided with the information they needed if they wanted to speak with an independent advocate. People’s friends and relatives were able to visit whenever they wanted to.
People’s support records were person centred and focused on what was important to them. The records were regularly reviewed. People’s personal preferences and how they wanted their personal care to be provided was recorded. People were encouraged to take part in activities that were important to them and were provided with the information they needed, in a format they could understand, if they wished to make a complaint.
People, relatives and staff spoke highly of the manager. The manager understood their responsibilities. People, staff and relatives were encouraged to contribute to the development of the service, although a process for obtaining formal feedback was not yet in place. Staff were encouraged to develop their roles. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided. Funding had been obtained from an external organisation to help fund improvements and to develop the service.