Equal People Mencap

At our last inspection of 5 April 2016, 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 found the service remained Good.

There was a registered manager at this location. 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.

There were enough staff available to safely support people. Staff managed people’s medicines in a safe way. Staff understood how to respond if they suspected people were being abused. Staff had received training in safeguarding adults at risk. Risks to people were assessed and management plans developed to guide staff on how to prevent and reduce avoidable harms to people. Lessons were learned from incidents and when things went wrong. Staff followed infection control procedures to reduce risks of infection.

Staff assessed people’s needs following recommended guidance. People were supported to meet their nutritional needs. Staff supported people to access health and social care services they required to maintain their health and well-being. Staff worked closely with other services to ensure people’s care and support were effectively delivered.

Staff continued to be well supported in their roles to be effective. They received regular training, supervisions and were appraised annually. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People consented to their care before it was delivered. Staff supported people to made decisions appropriately and promoted their rights.

Staff knew the people they supported including how to respond when they became anxious or presented behaviours which challenged. Staff treated people with dignity and respect. Staff encouraged and supported people to maintain relationships important to them. Staff communicated with people in the way they understood.

People had support plans in place which set out their needs and how their individual needs would be met. People’s needs and support plans were reviewed and updated regularly to reflect their current needs. The provider provided information to people in accessible formats.

People were encouraged to follow their interests and develop daily living skills. People took part in a range of activities they enjoyed. Staff promoted people’s independence in the way they supported them. Staff treated people as individuals and promoted their religious and cultural beliefs. The service was not providing end of life care at the time of our visit but the registered manager had experience in end of life and told us they would work closely with professionals when needed.

There was a complaints procedure in place which was accessible to people. People and their relatives told us they knew how to complain if they were unsatisfied with the service. The quality of the service was monitored and assessed so improvements could be made. The provider worked in partnership with other organisations to develop the service. Staff told us that they felt supported and had the leadership they needed. The registered manager met their statutory responsibilities to the CQC.

Equal People Mencap provides support with the activities of daily living to people with learning disabilities living in the community. The service covers the Royal Borough of Kensington and Chelsea and is based in the north Kensington area. There were 41 people using the service at the time of our visit.

The service had a registered manager in post. 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 using the service expressed positive views about the service and the staff. People felt safe and were supported by staff who knew how to keep them safe. Risks to people's health and safety were assessed and appropriately managed and people were supported by a sufficient number of staff.

The service received referrals from social workers. This information was used to inform and develop care plans in consultation with people and their family members (where appropriate). This ensured people’s support needs could be identified and risk assessments completed before staff began working with people.

People’s risk assessments covered a range of issues including personal care, finances and budgeting and access to community facilities. When required, staff supported people to make appointments and attend health appointments. There were protocols in place to respond to any medical emergencies or significant changes in a person’s health and well-being.

Where staff were responsible for prompting people’s medicines, staff had completed training in medicines administration and completed appropriate recording charts. People received the support they needed to safely manage their medicines and (where appropriate) were encouraged to be as independent as possible in this task.

Staff had the knowledge and skills to care for people effectively and felt well supported. Staff were familiar with the provider’s safeguarding policies and procedures and able to describe the actions they would take if they suspected abuse was taking place.

The provider was meeting the requirements of the Mental Capacity Act 2005 and protecting people’s rights. The staff we spoke with understood what the MCA is designed to do and described how they supported people to make decisions where possible. We saw that appropriate people had been involved in the decision making process and a care plan put into place which reflected the decision. Staff were aware of such decisions and told us that they still helped people to make their own decisions where possible.

People’s independence was promoted. People were supported to do the things they wanted to do, such as attend college, sport and recreational facilities. Staff were aware of people’s specific dietary needs and preferences and people received the level of support they required to have enough to eat and drink.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. The provider promoted people’s involvement in the way the service was run and sought feedback from people using the service and staff on a regular basis; this included surveys, staff team meetings and spot checks carried out by the registered manager. 02

People's views and experiences were taken into account in the way the service was provided and delivered. People we spoke to very happy with the care and support they received to live independent lives. 'They help me do what I want. I know they are always there'. 'They help me with around the house and remind me about things'. 'I'm always meet with staff to talk about what I need'.

Everyone had a care plan centred on their goals, needs and choices. Staff knew people well, and had regular meetings with them. Risks were assessed and appropriately managed and balanced with ensuring people's independence.

The service protected people from the risk of abuse and other risks because they took a proactive, inclusive approach to keeping people safe.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard. All staff received regular training to maintain and extend their competency. They also had supervision at least monthly and had annual appraisals.

People were made aware of the complaints system. People who used the service told us they had been made aware of the provider's complaints procedure and knew how to make a complaint.

Staff completed risk assessments and support plans for each person using the service. Key stakeholders as well as the person themselves, were involved in the development of support plans. People told us that they were satisfied with the support they received. One person described staff as 'very good'. People knew who their support workers were and what their support plans involved.

There were clear infection control guidelines in pictorial format for staff. Staff told us that infection control risk assessments were carried out in people's homes. Support staff had access to personal protective equipment such as aprons and gloves and there was information available to staff about how to manage blood and body fluids in people's homes.

Applicants were interviewed by a panel of four people and people who use the service were also involved in the process. The provider obtained training records, two references and a Criminal Records Bureau check from successful candidates.

Records we saw were clear, legible and concise. Records were kept securely and could be located promptly when needed. People's records were kept in a locked cabinet in the staff office.