Archived: Garland Support

Updated 24 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection. It took place on 13 and 20 July 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because the location provides a supported living service for adults who are often out during the day. We needed to be sure that they would be in so we could seek their views about the service.

The inspection was carried out by one adult social care inspector. Before the inspection we asked the provider to complete a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at information we had received about the service since the last inspection, such as notifications about significant incidents, and information from people who use the service, staff, relatives and other professionals.

On the first day of the inspection we visited the agency office where we spoke with the registered manager and five members of staff. We looked at records held in the agency office including four staff recruitment files, staff rotas, four support plans and quality monitoring and improvement records.

On the second day of the inspection we visited four people who received a service. We also met four members of staff and one relative. We looked at the records of care held in each person’s home including support plans, risk assessments, daily reports, medicine administration records, and records of support given to help people manage their weekly household budgets. After the inspection we spoke with a relative on the telephone, and received e mail contact from three staff and one social care professional.

Updated 24 August 2018

Garland Support is a supported living service for adults who have physical or learning disabilities and live in their own homes. At the time of this inspection there were five people with disabilities who received a range of support from the service, including personal care. Our inspection focussed on the support given to these five people. The service also provided support to people who did not require personal care. This part of the service is not covered by CQC legislation and therefore was not included in the inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, people’s independence and links with their community.

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Why the service is rated Good

People and their relatives told us the service was safe. Robust systems, processes and practices were in place to protect people from the risks including the risk of abuse, falls, fire and infection. Staff had received training on safeguarding. Risks to people’s health and safety had been assessed and staff had been given information and training about these as well. Staff understood specific health conditions and knew how to recognise signs of illness and when to seek medical intervention. People were supported to manage their medicines safely. The provider had systems in place to ensure that lessons were learnt and improvements made. As a result they had a low level of incidents and accidents.

Care was taken to recruit and select the right staff for the job. Recruitment processes helped the provider choose applicants with the right values and caring qualities for the job. A person told us “They are marvellous. Always kind.” There were enough staff employed to ensure that people always received support at the right times, and by staff they knew. A relative told us “[…] has a steady, regular staff team. Staff have got to know him. Staff have managed his behaviours well.”

People continued to receive a service that was effective. People told us they were very happy with the support they received. Each person received a timetable each week, in a format they could understand, to let them know who would be visiting them and at what times. Staff told us there were effective systems in place to manage their weekly rotas and ensure they knew who they were visiting each week, and when. The service was reliable.

Staff had the skills, knowledge and experience to deliver effective care and support. Staff received induction and ongoing training and updates on a range of topics relevant to the needs of the people they supported. They were also supported to gain relevant qualifications and to attend courses and training sessions to enable them to improve their knowledge and skills. A relative told us they were confident the staff were well trained, saying “I think they are a high calibre of staff.”

Consent to care and treatment was always sought in line with legislation and guidance. The service understood their legal responsibility to ensure they complied with the Mental Capacity Act. People were supported to make choices and decisions about all aspects of their lives, as far as they were able. People receive support from staff who respected and promoted equality and diversity.

People were supported to eat and drink enough to maintain a healthy balanced diet. Where people required support with this task, staff helped them choose the meals they wanted each week, go shopping for the ingredients and to prepare and cook the meals.

People continued to receive a service that was caring. A person who used the service told us, “It’s like a family. Staff are always kind and caring.” A relative said, “They deeply care. They will go the extra mile”. People were supported by small teams of staff who knew them well and understood the things that mattered to them, their likes and dislikes. People and their relatives praised the staff for their caring manner and gave examples of many “little kindnesses”. We heard how each member of staff brought their own special talents and skills to the job, such as a member of staff who always sat with a person to talk about and listen to the person’s stories and memories of their past. A member of staff was described as, “Just magic. A lovely warm personality.” We saw and heard staff smiling, encouraging and supporting people in a caring and friendly manner. People were involved and consulted on the service. Their views on the service had been sought in various ways including questionnaires, regular reviews and through forums held at their activity base known as The Hub for people who use the service.

People received personalised and responsive care from staff who knew and understood their needs. Support plans were drawn up and agreed with people before the service began. The plans were regularly reviewed and updated to ensure staff always had access to up-to-date information about all aspects of the person’s needs. People were given information about the service, including a copy of their support plan, in a format suited to their needs. They had also been given a copy of the complaints procedure in an accessible format. Concerns and complaints were responded and listened to and used to improve the quality of care. The service was pro-active in recognising mistakes, apologising and taking action to improve the service. A relative told us “They are very open. Even if they have made a mistake.”

People were supported to gain independence, learn new skills and achieve their goals and ambitions. People participated fully in the local community. Areas of support included helping people gain employment, attend college, go to places they liked and to do activities they enjoyed. The agency had set up an activity centre called The Hub which people could attend if they wished. The centre offered people a range of activities and outings. A relative told us “He has made new friends. He enjoys The Hub and group activities and outings.”

People told us they continued to receive a service that was well-led. Comments included “They have good values”. At the time of this inspection the registered manager had taken on a new role within the organisation. A new manager had been appointed. A few days after this inspection the new manager’s application to be the registered manager of the service, was approved. People, staff and relatives told us they liked the new manager. Comments included “[…] understands. He has regular meetings with the family and professionals. He has put a lot of time into [person’s] care plan.”

There was a clear management structure in place and staff were well supported. Staff were positive about their jobs and praised the management team. Comments included “This job is brilliant. I love it”.

The provider had quality monitoring processes in place to ensure the service was constantly improving. The views of people who used the service, relatives and staff had been sought in various ways and these were acted upon. A relative told us they had very good communication with the management team, saying “They are constantly seeking to improve things.”

Further information is in the detailed findings below