11 February 2016
During a routine inspection
The Norwich Office provides personal care to people with a learning disability who are living with their families. At the time of the inspection there were five people using the service.
There was registered manager in place overseeing this office and another one operated by the provider. 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 management of the Norwich Office was directly overseen by a service delivery manager, accountable to the registered persons.
People experienced a service that was safe. They received assistance from enough staff to fulfil their expected care packages and to meet their needs. Staff and the management team understood their obligations to report any concerns where someone may be at risk of abuse or harm. Staff also understood the risks to which people were exposed and how they needed to support them safely.
Where staff were involved in assisting to manage people's medicines, they did so safely.
The service people received was effective. Although most staff had not been trained in the Mental Capacity Act 2005, to understand how to support people who could not make decisions for themselves, they understood their responsibilities in this area. They ensured they sought consent and understood, if people were not able to express this verbally, how people communicated by gestures or behaviour whether they would accept assistance with their personal care. They worked with other professionals to present information in a clear and consistent way so that people would be able to understand.
Staff had a clear understanding of their roles and people’s needs. They had access to support from the management team when they needed it. They were alert to changes in people's well-being or health and worked with relatives to ensure people's health and welfare was promoted. This included supporting people to eat and drink enough to maintain good health, if this was needed as part of their care package.
People received support from staff who were kind and compassionate and who were respectful of people's privacy and dignity. Staff understood people's preferences, working with their relatives to establish these and their interests, if it was appropriate. Where people's needs changed, information was communicated promptly so that staff understood what was expected of them when they were delivering care.
People's representatives were confident that any concerns or complaints they wished to raise on behalf of their clients or family members would be properly addressed.
Systems for monitoring the quality and safety of the service and assessing people's experiences, were working well. The management team addressed promptly any issues that were raised with them. They had developed good relationships with people, their representatives and staff, who all expressed a high degree of confidence and satisfaction in the way the agency was being run and managed.