City Care Partnership Limited

Updated 10 August 2019

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

Inspection team:

The inspection was carried out by one inspector.

Service and service type:

This service provides care and support to people living in five ‘supported living’ settings, so that they can live 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.

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 a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. There were some people who use the service who’s behaviours might of been unsettled by a visit and we gave notice so that staff could prepare them and gain their consent. The inspector sent a photograph prior to the visit to help with the preparation.

What we did before 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 included information that the provider must notify us about. We also used feedback from professionals who work in the local authority commissioning and safeguarding teams. We used all of this information to plan our inspection.

During the inspection:

We visited three supported living houses and met with people at the provider's Yew Tree Hub complex. Overall we spoke with 14 people who used the service and four relatives about their experience of the care provided. We spoke with 13 members of staff including the provider, the registered manager, director, area manager, two team leaders, and five support workers. We met with members of the provider’s Central Support Team; the behaviour support team manager and an assistant psychologist.

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

We asked the registered manager to send us further documents after the inspection. This included training records and outcomes of quality audit checks. These were provided in a timely manner and this evidence was used to inform our judgements. After the inspection we spoke with three health professionals who worked closely with the service.

Updated 10 August 2019

About the service:

City Care Partnerships is a domiciliary care agency. It provides personal care and support to people living in their own houses and in five ‘supported living’ settings. They support autistic people and people with a range of complex learning disabilities. At the time of the inspection 16 people were being supported by the service.

People’s experience of using this service:

The service had improved its overall rating of good awarded at the last inspection in 2016 to Outstanding.

The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and this had led to highly person-centred care and support. The principles reflected the need for people with learning disabilities and autistic people to live meaningful lives that include control, choice, and independence.

People’s lives were greatly enhanced by innovative and creative person-centred support that maximised their opportunities for self-development and growth.

People told us the support from staff was ‘fantastic’ and ‘amazing’. Relatives told us that the staff team were “phenomenal” and “absolutely fantastic” in their understanding of supporting autistic people. They described the input of the service as being 'life-changing'.

Staff were passionate and really cared about making a difference to the people they supported so that they could lead the best lives possible. People were supported to lead fulfilling, active lives and to be active citizens within the local and wider community. This had led to people’s aspirations and dreams being realised.

Great emphasis was placed on people being physically and mentally active to promote well-being. Yew Tree Hub, the provider’s unique activity hub complex, was a key feature of the services success. People worked at Yew Tree dog kennels, helped to run a stable and livery centre and to grow and sell organic farm produce. Expressive arts were a major focus with many opportunities for dance, song, music, art and drama. This had led to long-term employment and volunteering opportunities that people and their relatives had previously not thought possible.

The service had a proven track record of providing exceptional care and specialist support. This was achieved through input from the providers Central Support Team (CST) employing a clinical psychologist, a speech and language therapist and trained behaviour specialists. Great emphasis was placed on analysing and using data to understand people’s behaviours that maybe challenging and communication needs.

The staff team were highly trained and this had led to a major reduction in behaviours that may challenge the service and the need to use physical interventions with people. People were exceptionally well supported when transitioning between services, especially for people whose previous placements had broken down. As a result people’s outcomes and quality of life had been significantly improved through this exceptional support planning.

People were expertly 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 were key to this practice.

People we spoke with and staff told us the leadership and management was inspiring. The service acted as a role model for other services sharing ideas and best practice and had been nationally acknowledged as a leader in the learning disability sector.

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 August 2016).

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.