Mencap - Dorset Support Service

Updated 15 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 16 January 2020 and ended on 17 January 2020.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and

improvements they plan to make. This information helps support our inspections. We also contacted commissioners and a local authority safeguarding team for information. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service. We also spoke with five members of staff including the registered manager, service manager and three support workers.

We reviewed a range of records. This included three people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment and training. A variety of records relating to the management of the service, including quality assurance audits, supervision matrix and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The registered manager sent us additional information on request including: a service action plan, two positive case studies, staff meeting minutes and a business continuity plan. We spoke with three relatives by telephone about their experience of the care provided. We contacted one professional for feedback but did not receive a response.

Updated 15 February 2020

About the service

Mencap Dorset Support Service is a supported living service. The agency specialises in providing personal care and support for people with a learning disability or mental health condition living in the community. The service was currently supporting eight people receiving a regulated activity of personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection the agency was providing support with personal care to eight people.

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.

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

People told us they felt safe, happy and well cared for by Mencap Dorset Support Service. Relatives spoke positively about the care their family members received and the difference it had made to their lives. Staff knew what signs and symptoms could indicate people are experiencing harm or abuse. Staff felt confident management would listen and act if they raised concerns.

The service had robust recruitment processes to ensure people were supported by staff with the necessary skills, experience and character. There were enough staff to keep people safe and meet their individual needs. Staff had a good understanding of people’s individual risks and how they could work with them to minimise the risks.

People were supported by staff who had received mandatory and specialist training to help them meet their diverse and changing needs. Staff said the training was good. Staff competency was monitored on an ongoing basis through formal observations, supervision and performance appraisals.

People’s support needs, abilities and desired outcomes were identified, assessed and monitored in personalised care plans. People’s needs were reviewed with their involvement. When required, staff ensured people had timely access to healthcare services in order to maintain their health and wellbeing. This included GPs, physiotherapists, diabetic nurses and dentists. Relatives told us they were listened to and involved.

The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. One person told us, “You can choose what you wear, who you go out with, you’re not restricted here.”

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. Staff demonstrated a good understanding of the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people there. This provides protection for people who do not have capacity to make decisions for themselves. Staff consistently sought people’s consent before offering to support them with their daily lives.

Staff treated people with respect and kindness. Interactions were warm, natural and punctuated with appropriate humour. Staff had been given time to get to know people well including how they wished to spend their time, who they wanted to spend time with and their preferred means of communication. People’s right to privacy and dignity was respected at all times.

People were encouraged and supported to maintain relationships with relatives and friends and be active participants in their local community. People were encouraged and supported to engage in meaningful activities that matched their tastes and abilities. This enabled people to lead full and active lives. Activities included supported holidays abroad, gardening, quiet time, day services, volunteering, painting and attending sporting events.

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Staff had created opportunities for people to maximise their independence and life skills. This had enabled people to develop their confidence and embrace new challenges.

Staff told us they enjoyed their jobs and felt supported by their colleagues and the management. One staff member expressed, “The other staff are great to work with. They all really care about the people.” Quarterly engagement days were held to give staff an opportunity to speak with area and regional managers and share their views about the service.

A range of audits and checks helped ensure service quality was maintained and areas for improvement identified. In addition, annual surveys and reflective events were undertaken to determine what the service was doing well and where it could make improvements. Feedback was analysed and used to create service action plans.

Staff felt recognised and praised. The registered manager said, “I’m proud of my staff team and the work we do, [and also] the adaptability and flexibility of the staff and managers.” Equality and diversity was actively considered for people and staff. Reasonable adjustments had been made to support staff with health conditions, family and study commitments. This was helping to ensure retention of staff and consistency of care for people supported by the service.

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

Rating at last inspection

The last rating for this service was good (published 10 February 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.