New Beginnings North East Ltd

Updated 13 July 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.

Inspection site visit activity started on 8 March 2018 and ended on 14 March 2018 and was announced. It included visits to people’s homes and a focus group with staff. We visited the office location on 8, 9 and 14 March 2018 to see the registered managers and office staff; and to review care records and policies and procedures.

The provider was given one week’s notice about the inspection because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office. We also wanted to arrange to speak to people who used the service. The inspection was carried out by one inspector.

Before the inspection, we reviewed all of the information we held about the service including statutory notifications the provider had sent us. Notifications are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of. We contacted two local authority commissioning and safeguarding teams and the local Healthwatch. Healthwatch are a consumer champion in health and care. They ensure the voice of the consumer is heard by those who commission, deliver and regulate health and care services.

For this inspection we did not ask the provider to complete 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 improvements they plan to make.

We met with five people who used the service in the office as they were visiting to take part in an activity. We also visited the homes of eight people who used the service. We spoke over the telephone with seven relatives. We spoke with both of the registered managers, and held a staff focus group with six department managers and deputies, two team leaders, a HR assistant and two members of staff who focussed on activities, personalisation and community involvement. Outside of the focus group we also talked with one department manager, five team leaders and six support workers. We looked at seven people’s care records, four staff files, staff training records and other records related to the management of the service. Before our inspection, we sent out questionnaires to people who used the service, relatives and community professionals to gather their views about the service provided. We received responses from 19 people, nine relatives and two community professionals.

Updated 13 July 2018

We inspected the New Beginnings North East Ltd office on 8, 9 and 15 March 2018. The inspection was announced, as we gave the provider one week’s notice to enable staff to arrange ways for us to meet people who used the service. During our inspection visits on 9 and 15 March 2018, we visited people in their homes.

When we last inspected the service in December 2015, we found the provider was meeting legal requirements and rated the service as Good. At this inspection in March 2018, we have rated the service as Outstanding.

New Beginnings North East Ltd provides care and support to people with learning disabilities living in 'supported living' settings, so that they can live in their own home as independently as possible. 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. At the time of this inspection, the service provided care to 76 people.

Not everyone using New Beginnings North East Ltd receives 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.

Two registered managers were in place. 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.

New Beginnings North East Ltd has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The provider, registered managers and staff put people at the forefront of everything they did. The provider created an ethos and culture of individualised and person-centred care. People’s rights were championed and they were supported to live full and enriched lives. People were as independent as they could be. A positive approach to risks enabled people to live more fulfilled lives. The reduction of staff input to people’s individual care was carefully planned.

The provider understood the value of community. They supported people to be active members of their local area. Staff valued people, their skills and the contributions they made. People were supported to volunteer for charitable organisations. Staff had helped people to find roles which matched their interests. Staff celebrated people’s achievements and displayed passion when talking about the goals people had worked towards.

Staff went ‘the extra mile’ to enable people to live fulfilling lives. Staff changed their working patterns to support people to go to rave music events and rock clubs until the early hours in the morning.

People we spoke with told us they would not hesitate in sharing any concerns. Complaints were well managed, and had been investigated and responded to. The registered managers acknowledged the value to the service from any complaint as an opportunity to improve their service.

There was a strong, visible person-centred culture. People were supported by a core staff team who provided consistent care. Staff knew people very well. People were involved in the recruitment process, and selected their staff teams based on their personalities and common interests.

People were very comfortable with their support staff. One relative told us the service had ‘transformed’ their family member so they were no longer unhappy.

The provider set a culture of openness and transparency. They built reflection, and opportunities to identify lessons learned, into all of their managerial records. They strived towards continuous improvement and kept a log of all shared learning opportunities where changes had been made to working practice following feedback from people, relatives, staff and other services.

The provider set high expectations for the service and had a robust quality assurance system to ensure standards were met. Thorough checks were carried out regularly of staff performance. Annual home inspections were in depth. Action plans to address areas for improvement had been monitored and completed.

People and relatives spoke very highly of all aspects of the service. They told us they felt safe with staff employed by the service. Some people who used the service, at times, displayed behaviours which could pose a risk to themselves other others. Support plans communicated known triggers, and how staff should support people to reduce the likelihood of people feeling anxious or aggressive.

People's medicines were well managed. The service was taking part in a project to reduce the use of medicines which affected people’s mood. Staff followed processes to minimise the spread of infection.

Staff had undertaken training in a range of subjects, related to care, safety and the values of the service to enable them to deliver care to the high standards expected. Staff skills were assessed to determine if they were competent to deliver the task safely.

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 supported this practice.