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Inspection carried out on 21 January 2020

During a routine inspection

About the service

Pendennis House was providing care and support to 6 people at the time of the inspection. Five people were living in their own accommodation close to the main office of the domiciliary care service and one person lived in the community some distance from the main office. Support was tailored according to people's assessed needs within the context of people's individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes.

The service provides specialist support to people with learning disabilities, autism, mental health needs and physical disabilities to help them to live as independently as possible and achieve their goals. Staff provided flexible support across 24 hours, in some instances overnight.

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’s experience of using this service and what we found

The service was exceptional in encouraging people to live as full a life as possible and supported them to achieve the best possible outcomes. People's confidence, independence and wellbeing had improved since they began using the service.

Dedicated and enthusiastic staff ensured that people's daily life was filled with meaningful opportunities, entertainment and involvement in making friends and reducing social isolation.

People felt safe using the service. Staff had been trained to understand how to manage risks to people and how to report any concerns they had about people.

Staff understood how to protect people from abuse through training and literature available to them. Staff were familiar with the policies used by the service.

Recruitment processes were thorough to ensure staff were safe to work with people using the service.

Staff had received essential training and support, and feedback from people indicated that they knew the best way to care for them in line with their needs and preferences.

The service had systems to ensure risks were managed and people were kept safe. People received effective care from a well-supported and trained staff team.

People and relatives told us the service was person-centred. They said care was delivered in line with preferences and wishes. People were consulted with and involved in developing their care wherever possible.

People told us that they had no concerns around staff respecting their dignity and privacy in their own homes. One person told us, "Yes they [staff] give me privacy".

People told us they were confident concerns were always listened to and acted upon if necessary by management team.

Lessons were learned from incidents and accidents by reflecting on them and putting systems in place to mitigate any further issues. Managers and staff were consistently open and transparent when things went wrong and kept records to demonstrate this.

People told us the service was well-led. Staff told us, “It’s just an inclusive team. I have a lot of confidence in the management team” and “Just knowing there is always somebody there you can trust to support you means so much.”

The management team and staff had clear roles and responsibilities and were committed to ensuring the service provided was of a consistent standard. There was an emphasis on developing a person-centred culture within the service.

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

Inspection carried out on 6 June 2017

During a routine inspection

Pendennis House is a domiciliary care agency which provides support to people in their own homes. At the time of the inspection they provided care and support 24 hours a day to two people living in their own accommodation in close proximity to the service’s main office in Wadebridge. The service provides specialised 24 hour support including socialisation and inclusion, access to the community or assistance to attend appointments.

This was the first inspection of the service since it registered in October 2016. The inspection was announced. We told the provider three days before our inspection visit that we would be coming. This was because we wanted to make sure people would be at the service to speak with us.

There was a registered manager in post. 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.

The registered manager employed enough staff to ensure the service was run safely and effectively. The agency only accepted packages of care if the registered manager was satisfied there were enough suitably qualified staff available. Staff rotas were planned in advance and people received a consistent and reliable service from staff who clearly understood and could respond to people’s needs.

Staff were trained in safeguarding and they knew how to keep people safe from avoidable harm. People had individualised risk assessments in place that gave guidance to staff on keeping them safe. There was information about people’s levels of risk and how it might be managed, also routines and personal preferences including some situations which might cause anxiety or stress. The provider had policies and procedures and systems in place for the safe recruitment of new staff. Staff completed a recruitment process to ensure they had the appropriate skills and knowledge to carry out their role.

Care records were person centred and contained specific detailed information to guide staff who were supporting people. The care plans included information about the person in a format which was presented in a meaningful way for people to understand. This included large print and pictorial information. Staff said they knew people’s needs because they had the information about the person available to them and information was shared daily between the registered manager and staff.

People told us and we observed people felt safe and secure when receiving support. People received consistent support from care workers who knew them well. One person said, “I’m doing very well. Yes, get on well (with staff).”

Staff received training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to meet people’s care and support needs. One staff member said, “I think the training is very good. We (staff) had training to meet the needs of a person before they started using the service. It meant we understood what they needed and how to approach them."

Where people did not have the capacity to make certain decisions, or had limited capacity, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had a good understanding of the principles of the legislation and training was updated as necessary.

Accidents and incidents were recorded, reviewed and monitored by the registered manager. The registered manager was aware of their responsibility to report certain incidents to external bodies, such as the local authority and CQC as necessary.

Medicines were safely managed and staff followed best practice guidance. Medicines were administered safely, timely and hygienically. Medicine Administration Records (MARs) were used to record any assist