27 November 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 was planned to check 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.
The inspection was announced. We gave the provider two working days' notice of our inspection as it was a domiciliary care service and we needed to be sure key staff members would be available. The inspection was conducted by one inspector. The inspector visited the service's office on 30 and 31 August 2018 to meet office staff and to review care records, policies and procedures. The registered manager was unavailable in person, but we spoke to them through face to face video calls.
Before the inspection, the registered manager completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. Notifications are information about specific important events the service is legally required to tell us about. We used the information to help focus the inspection.
During the inspection we spoke with and visited four people who used the service and spoke to their family members. We also received written feedback from three family members following the inspection. We spoke with a director of the provider's company, the registered manager, two service co-ordinators, and four care workers. We looked at care records for five people. We also reviewed records about how the service was managed, including safeguarding records and staff training and recruitment records. We received feedback from three social care professionals and one healthcare professional.
We last inspected the service in May 2017 when we did not identify any breaches of regulation, but rated the service as 'Requires improvement'.
27 November 2018
Ryde House Outreach provides support to people living with a learning disability, to access the community and provide respite for their main carer. Not everyone using Ryde House Outreach Service received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
Our inspection was based on the care and support provided to fourteen people receiving personal care, with three of these being young people. Each person received a variety of care hours from the agency depending on their level of need. Some people had a learning disability or autism and were living in individual supported living flats; they required support to enable them to retain a level of independence. Other people were receiving support in their own home or to access activities in the community.
This inspection was conducted on 30 and 31 August 2018 and was announced. We gave the provider two working days' notice of our inspection as we needed to be sure key staff members would be available.
We last inspected the service in March 2017 when we did not identify any breaches of regulation, but rated the service as 'Requires improvement'. At this inspection, we found improvements had been made.
There was a registered manager in place. A registered manager is a person who has registered with the CQC 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 home is run.
There was a genuine person-centred culture, where staff displayed empathy and worked with people and their family members to understand how best to support them. People were put at the centre of everything staff did, to help ensure their needs, wishes and hopes were understood and to help them to live fulfilled lives. The attitude and knowledge of staff and management clearly had a positive impact on people and their families.
There was a strong emphasis on continuity of care and learning, to maximise the opportunities for people. Training and guidance for families was provided free of charge to assist with their understanding and to support their relative to have continuity of care. People were provided with core staff teams to help provide them with continuity of care and develop trusting relationships.
Family members, staff and professionals described the service as being exceptionally well led. Staff felt well supported and valued by the management team. They were confident in the management team’s abilities and felt that their views would be listened to and actions taken where required.
The management team and staff had developed exceptionally positive and supportive relationships with family members. The service went above and beyond to support families and people when in crisis.
There was a strong emphasis on continually striving to improve the service. The provider was fully engaged with the running of the service. The registered manager was proactive to support effective joint working with professionals and remain up to date on best practice guidance.
People, their families, professionals and staff were engaged in the running of the service and encouraged to regularly feedback views on service delivery, and share ideas and suggestions on how the service could be improved. Quality assurance questionnaires were sent to people, their families, staff and professionals annually. Feedback gathered was reviewed to support the registered manager and staff to ensure improvements could be made.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. There was overwhelming evidence that the core values of choice, promotion of independence and community inclusion; were at the centre of people's day to day support. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service took a key role in the local community and were actively involved in building further links. Ryde House Outreach service supported a scheme run by the local hospice, which provided an entertainment event for young adults living in the community with complex needs and life limiting conditions. The service also undertook fundraising events for the local hospice. The service offered autism training to the police and other public-sector employees, who may come in to contact with people with additional needs.
Staff were clear about their safeguarding responsibilities and knew how to recognise and report potential abuse. Staff carried out their roles and responsibilities effectively. Staff had an excellent understanding of managing risks and supported people to reach their full potential through consistent, personalised care.
People were supported by staff who were highly skilled, and knowledgeable in caring for people with additional needs. Staff were skilled in helping people to express their views and communicated with them in ways they could understand.
Risks to people were robustly explored and recorded. The registered manager and staff had assessed individual risks to people and acted to minimise the likelihood of harm. People were supported with their medicines by staff who had been trained and assessed as competent.
Staff understood and followed the principles of the Mental Capacity Act 2005 (MCA) and were aware of people's rights to refuse care. The management team and staff worked to ensure that people’s choices and wishes were respected.
Technology was used proactively to both support people’s safety and communication needs.