Royal Mencap Society - Domiciliary Care Services and Shared Lives - West London

Royal Mencap Society – Domiciliary Care Services and Shared Lives – West London is a supported living service providing personal care to people living in shared flats. At the time of the inspection there were 29 people using the service who received personal care across seven supported living schemes across South and West London. Personal care is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Royal Mencap Society – Domiciliary Care Services and Shared Lives – West London also provides a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes.

People’s experience of using this service and what we found

People and their relatives told us the service provided meant they were kept safe from harm and abuse. Staff levels were flexible and met the needs of people using the service. The provider had appropriate risk management procedures in place which helped to ensure people continued to lead independent lives whilst at the same time keeping them as safe as possible. People were supported to take their medicines in a safe manner from staff who were trained to do so. Staff followed good infection control guidance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.

Staff were recruited based on the values they demonstrated during the recruitment process and if these aligned with the provider’s values. Staff completed a through induction and received ongoing observation of their practice. People were supported to access healthcare services and had care and support plans which helped staff to manage their health needs. People received appropriate support in relation to their eating and drinking.

The service was caring. People felt listened to and their views were considered. Long lasting, meaningful relationships had been established between people using the service and care workers. Staff respected people’s privacy and dignity and accommodated people’s diverse needs.

Care records reflected people’s current support needs and key workers worked with people to identify goals which they supported them to achieve. People led active lives, pursing their interests and accessing community services. People’s communication needs were met. The provider listened when complaints were made and resolved them.

The provider placed great emphasis on the values of the organisation and worked hard to ensure this was apparent across all areas of the organisation, including people and staff. Staff were recruited based on their values and they were expected to demonstrate how they lived these values during their supervision and appraisal. Staff who exceeded these values were recognised for their excellence. People’s views were considered when recruiting staff and there were a number of internal working groups they were encouraged to take part in.

Rating at last inspection

The last rating for this service was Outstanding (published 26 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

This service provides personal care and support to people living in supported living schemes across the London boroughs of Hounslow, Richmond, Hillingdon, Kingston and Wandsworth. At the time of our inspection there were 45 people using the service. The service was required to have a registered manager in post and did not have one at the time of our inspection. However, a service manager was in post and was in the process of applying for their registration. We confirmed that this process was completed shortly after our visit and the manager's status was updated to registered. 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 manager of this service had worked for the same provider for a number of years and was already familiar with the service when they came into post.

People had built very good relationships with staff, who were friendly and respectful and who knew people well. The service used creative and innovative methods of supporting people to express their views and make choices about their care, including the use of accessible technology where needed. Staff made an effort to learn how to communicate with people whose first language was not English.

The service had a strong commitment to promoting people’s privacy, dignity and independence. People had access to private space whenever they needed it. Staff worked closely with people to build their confidence and learn to do more for themselves.

The provider used a person-centred approach to care planning based on evidence-based measures of quality of life. Support plans were personalised and centred around people’s preferences, views and experiences as well as their care and support needs. They took into account people’s history, family relationships and religious and cultural needs. People’s care and support was planned in such a way as to facilitate working towards their goals and ambitions. The provider recognised people’s achievements and encouraged them to always improve by setting new targets whenever their care was reviewed.

People received support to engage in a variety of activities to suit their tastes and abilities, both at home and in the wider community. This included taking more responsibility for their own household tasks but also pursuing their interests and hobbies, making new friends and finding new interests. Staff supported people to pursue education and employment opportunities and to join social groups. They actively supported people to strengthen existing friendships and arranged activities to help ensure people did not lose touch with their friends.

People were satisfied with how the service responded to their complaints and concerns. There was an accessible complaints procedure and records showed the manager dealt with complaints according to the procedure. Managers sought people’s feedback in accessible ways, giving equal opportunities to people who did not communicate verbally.

Staff took pride in the provider’s visible person-centred culture with a clear vision, strong values and a reputation for providing good support to people with learning disabilities. Leadership was accessible and people, staff and others involved with the service had opportunities to express their views about the service. Managers used people’s feedback to improve services in a variety of ways.

The registered manager used several tools to assess, monitor and improve the quality of the service including internal audits carried out by people who used similar services operated by the same provider. They assessed the quality of the service against standards that were based on people’s feedback about the care and support they wanted from services. People were also involved in the recruitment and selection of new staff. The provider worked to challenge discrimination and stigma in a variety of ways, including supporting people to publish articles about their experience of discrimination.

Staff knew how to keep people safe, because there were detailed risk management plans to reduce risks. Staff supported people to make sure their homes were safe. They received suitable training in safeguarding people from abuse and there were procedures in place to protect people from financial and other abuse. Medicines were managed safely.

There were enough staff to keep people safe and appropriate arrangements for emergency staff cover. Recruitment processes were designed to ensure only suitable staff were selected to work with people.

People benefited from being cared for by staff who received suitable, good quality training that was relevant to their work. Staff received regular support from managers and had opportunities to learn and discuss good practice with their colleagues.

Staff were aware of their duties under the Mental Capacity Act 2005. They obtained people’s consent before carrying out care tasks and followed legal requirements where people did not have the capacity to consent.

Staff supported people to choose food they liked and to eat healthily. Staff ensured people had the information they needed to maintain a healthy lifestyle whilst respecting their choices about how they wanted to live. People had detailed plans to help staff and health professionals provide the care and support they needed to remain healthy and manage any existing health conditions.