Options

Updated 14 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Options is a domiciliary care agency that provides care and support for people with learning disability living in their own homes or in supported living accommodation where staff support people 24 hours a day. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 30 July 2019 and ended on 06 August 2019. We visited the office location on 30 July 2019. We then we visited two supported living services on the 31 July 2019. We provided feedback to the registered manager and regional manager on our findings on the 6 August 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with nine members of staff including the registered manager and the regional manager.

We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke with two relatives on the telephone to gain their views and experience of the service.

Updated 14 August 2019

About the service

Options is registered to provide personal care and support to people in their own homes. The service operates in Bristol, South Gloucestershire, Bath and North East Somerset and North Somerset. The service supports people with a learning disability, brain acquired injury or mental health to live independently or in communal supported living services. Some people received 24 hour support made up of individual hours and shared support living in shared housing.

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.

There were 12 people receiving personal care at the time of the inspection. There were also 38 other people receiving support services from the agency such as support with social activities but not help with personal care.

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

People received care that was safe, effective, caring and responsive. People and their relatives spoke positively about the support they received.

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 for them to gain new skills and become more independent. The service was responsive in this area encouraging people to network and foster positive relationships with not only the staff but other people using the service.

There was sufficient staff to support people who had the necessary skills and commitment to provide care that was person centred. Care was commissioned on a very individualised basis. Staff promoted independence with some people positively reducing their hours of personal care because of the skills they had gained.

People were supported to have choice and control of their life 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 had information in a way they could understand enabling them to make decisions about the care and support they needed.

People were supported by staff that were caring in their approach enabling them to lead the life they wanted. This included supporting people to keep in contact with friends and family. People were supported to make decisions about their care and the way they wanted to live.

The service was well led. There were systems to check and monitor the quality. This again involved people, staff and family.

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 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has remained good. This is based on the findings at this inspection.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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.