Mencap - Yeovil Support Service

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.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: The service had support plans and guidance in place but some important information was not always included. Recruitment processes were safe, and the provider was taking active steps to recruit and retain staff. The service supported people to have choice, control and independence. Staff communicated with people in ways that met their needs. Care was person centred and promoted choice and independence. People were supported to achieve positive outcomes. People were happy with the support they received.

Right Care: Staff were aware of the signs of abuse and they were aware of how to report any concerns through the appropriate channels. Staff promoted equality and diversity in their support for people.

Right Culture: The systems to monitor the quality of the service were not always fully effective in ensuring shortfalls were identified. The provider was working hard to improve their oversight and governance of the service. The values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. Staff understood people well and were responsive to their needs.

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 requires improvement (published 14 September 2019). At this inspection we found the service had improved and was now good.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mencap Yeovil Support Services on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Mencap Yeovil Support Service is a domiciliary care agency. The agency specialises in providing personal care and support for people with a learning disability or mental health condition living in the community. Mencap Yeovil Support Service is classed as a small agency which means that it provides support with personal care to no more than 100 people.

Not everyone who used the service received personal care. The Care Quality Commission (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 this inspection the agency was providing support with personal care to 10 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

Quality monitoring systems included audits to ensure people received good care. However, these were not always effective as mangers had not identified concerns raised throughout this inspection.

Medicine management was not robust. The service did not always follow relevant national guidelines around storing medicines, giving them to people, and disposing of them. This also applied to non-prescribed medicines. We have made a recommendation about the management of some medicines.

The provider had not considered the Mental Capacity Act 2005 fully. People were not always supported to have maximum choice and control of their lives and staff did not fully support people in the least restrictive way possible and in their best interests. We have made a recommendation that the provider reviews their current MCA systems and align them to current guidance and legislation.

The service applied the principals and values of Registering the right support and other best practice guidance.

People were supported by staff that were caring and treated them with dignity and respect. Staff understood the needs of the people they supported well and knew them as a person. All the feedback we received from people and their relatives was positive.

Risks of abuse to people were minimised. Assessments of people’s needs identified known risks and risk management guidance was produced for staff which they understood.

People were supported by staff who received regular training and felt supported by the registered manager and both service managers.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard [AIS]. The standard was introduced to make sure people are given information in a way they can understand. The registered manager was aware of the AIS and ensured information was shared in an accessible way.

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 1 March 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.

Mencap Yeovil Support Services provides personal care and support for people with a learning disability or mental health condition living in the community. The care and support is provided for people living in supported housing in the Yeovil area. People who live in the shared supported living properties have individual tenancy agreements. At the time of the inspection Mencap Yeovil Support Services were providing support for nine people receiving personal care. We met two people who were living at one of the supported living houses. We also observed how people interacted with staff and whether they were relaxed and happy.

This was the organisations first inspection since they registered at their new address in March 2015.

There was a registered manager in post. 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.

People were supported by sufficient numbers of staff who had clear knowledge and understanding of their personal needs, likes and dislikes. Staff had a good understanding of how people preferred to be supported both in their home and within the community. People were able to talk with senior staff in the office at any time as the service managers also worked shifts in the supported living units. This meant the staff in the office knew people very well. People who received care and support from Mencap Yeovil Support Services indicated they were happy with the service provided. One person said, “They are all brilliant, I am really happy.” Another person said, “I think they look after us very well.”

People’s care needs were recorded and reviewed regularly with staff and the person receiving the care. All support plans included written consent to care if people agreed or were able to sign. Support workers had comprehensive information and guidance in support plans to deliver consistent care the way people preferred. We found staff were motivated and committed to ensuring people received the agreed level of support. Each person had a core team of support staff specifically assigned to them. This ensured people were familiar with the staff who supported them and had managed to build trusting relationships.

Staff told us the training they received was good and that the training could be very specific to people’s needs if something was identified. They explained they had attended autism awareness training and MAPA training. This is ‘Management of Actual or Potential Aggression’ training. This training enables staff to understand how to de-escalate potentially challenging incidents. Staff said this gave them the skills they needed to recognise the triggers which could lead to behaviours that could be challenging for staff and react positively.

We observed people were cared for and supported by staff who were polite, compassionate and caring. People receiving the service had a very relaxed and cheerful relationship with the support workers supporting them at the time of our visit. Staff spoke passionately about the care and support they provided whilst maintaining confidentiality.

People were protected from abuse because the provider had systems in place to ensure checks for new staff, such as references and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.

The Mencap Society’s vision is, “A world where people with a learning disability are valued equally, listened to and included.” The registered manager said they worked on the principles of the organisations vision and values. The organisation values are, “Trustworthy, Inclusive, Caring, Challenging and Positive.” The visions and values were supported by staff who sought to ensure people achieved the best they could. Staff also discussed the organisation values during their one to one meetings with their line manager.

The service had a complaints policy and procedure that was included in people’s support plans. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately.

There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. People were involved in staff recruitment which meant they could say about the type of person they wanted to provide care and support in the service. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.