Sunnyside Domicilliary Support Services Limited

Sunnyside Domiciliary Support Services Limited was providing personal care and support to three people at the time of inspection. Although the service supported more people than this, others did not need support with their personal care. Some people were living in a shared supported living setting and others were living in their own individual flats. The service provides specialist support to people with learning disabilities and autism, to help them to live as independently as possible and achieve their goals. Staff provided flexible support across 24 hours, including overnight staff sleeping in.

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 lived in ordinary houses or blocks of flats with no signs to identify the accommodation was supported by staff. Staff did not wear a uniform, instead they wore their own clothes to make sure there were no obvious signs that others would recognise them as staff. People had access to a shared garden and shared communal areas where they could meet to socialise with others.

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

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent. Staff supported people to make the choices and decisions they were able to on a day to day basis. People were part of the local community, accessing local shops, leisure and work opportunities.

There were enough staff to make sure people received the support they needed, including going out to their chosen activities or work opportunities. New staff were recruited in a safe way to make sure only suitable staff were employed. Some people needed more support to maintain their safety than others. Risks were carefully and positively managed while promoting independence. Staff understood their responsibilities in safeguarding people from abuse and helping people to understand how to stay safe.

Staff received the training, support and supervision they needed to carry out their role and consider their personal development. Staff supported people to maintain and improve their health by encouraging a healthy diet and to access healthcare when needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s care and support was planned and provided in a way that put them at the centre of planning. Staff knew people well, their likes, dislikes and what and who was important to them. The individual way people communicated was key to their support, including verbally, or by their behaviour or body language.

There was an open culture, led by a registered manager, who was also the provider, and described by staff as being approachable and supportive. People knew the registered manager well and spoke about them. The registered manager had a good oversight of the service, using their monitoring processes and visiting often, to make sure people received a good quality and safe service.

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 15 February 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.

Sunnyside Domiciliary Support Services provides a service to people living in supported living accommodation in the London Borough of Bromley, as well as to people living in their own homes in the borough. Some people received personal care. At the time of the inspection, there were six people using the service, including four people who lived in a purpose built block of flats, which the local authority used for supported accommodation. The accommodation was maintained and owned by a housing association.

The service had a registered manager. 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 to maintain healthy diets and ensure their nutritional requirements were met. They had access to treatment from health professionals and staff contacted them in emergencies. There were recruitment procedures in place and staff were recruited safely. People were prompted to take their medicines as prescribed.

Staff respected people's privacy and choice. They told us they had support, training and supervision. They had knowledge of safeguarding and whistle blowing procedures and were able to describe the steps they should take to protect people from abuse and how to report incidents of abuse. Records showed they regularly attended staff meetings with the management team.

People told us they made their own decisions regarding various day-to-day tasks including choices of food, activities and daily routines. We noted there were systems in place that adhered to the requirements of the Mental Capacity Act 2005 (MCA) and they were implemented when required.

Each person had a support plan which stated their support needs. The support plans were regularly reviewed to reflect any changing needs. People felt independent and had improved their daily living skills whilst in the service.

People and relatives told us they knew how to make a complaint. They said staff listened to them and they were happy with the way the registered manager responded to complaints.

The registered manager had systems in place for auditing and monitoring the service to ensure quality was being maintained. Fire safety checks took place and people's finances and medicines were regularly audited. A survey questionnaire was distributed to people and their relatives to ask them for their opinion about their experience using the service. The registered manager analysed the responses to the questionnaires and responded to any feedback to help improve the service.

We found that the provider had taken action to address the identified concerns around the recruitment checks for staff. This meant that only staff who were of good character, had the qualifications, skills and experience and were physically and mentally fit for the role of working with vulnerable people were employed by the service.

People and their relatives told us they were visited regularly by the management and that the service was usually responsive to requests. They also said that they felt confident with reporting any concerns to the manager in order for the appropriate action to be taken.

People we spoke with told us they "Liked" the staff. One person's relative said that staff were "Excellent" and "Always go out of their way to help". However, we found that appropriate checks had not always been completed to ensure that staff were suitable to work with vulnerable adults.

We found that the service gained regular feedback from people and had robust quality and assurance procedures in place to monitor the effectiveness and safety of the care and support provided.

Representatives of people who used the service felt their relatives were treated with respect, their dignity was promoted and they were supported to meet their care needs, whilst being enabled to maintain and develop their independence. Staff said they were well supported by the registered manager and were given regular opportunities to talk with him. Staff also told us they attended relevant training courses to inform and direct their work, and they received regular supervision and annual appraisal. The provider and staff were aware of their responsibilities regarding protecting vulnerable people from abuse. Staff told us they knew how to raise concerns and would not hesitate to do so if they were concerned. The provider had quality assurance systems in place to check that the quality of the service being delivered was meeting people's needs.