365 support services

365 support services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service also provides care and support to people living in 11 '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.

Not everyone using 365 support services 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. The service currently provides a service to 82 people and supports 1 person with a regulated activity.

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

Although, risks to people were identified and managed and mitigated by staff to lessen the risk of harm to people, further information was required in peoples' support plans, to ensure sufficient guidance to staff. We have made a recommendation about this.

Accidents and incidents were recorded appropriately and analysed for any patterns or trends to help prevent the risk of recurrence.

People received their medications as prescribed and by staff who were trained and competent.

Staff recruitment processes ensured staff were safe to work with people. In addition to mandatory training, staff received more specialised training, to help deliver care to people which was tailored to their specific health and support requirements.

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.

We observed staff support and interact with people in a respectful way. It was evident staff enjoyed close relationships with the people they supported.

The management team was committed to delivering high-quality and individualised care to people, staff understood, shared and practiced these values. However, governance processes required review to ensure their efficiency. We have made a recommendation about this.

Although people were invited to provide feedback on the service, improvements were required to quality assurance arrangements. We have made a recommendation about this.

The service worked in collaboration and partnership with other relevant organisations to help achieve better and more positive outcomes for people.

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 (report published 29 August 2018).

Why we inspected

We received concerns in relation to potential incidents and staffing. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 365 Support on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using 365 Support Services 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. Overall the service currently provides a service to 82 people living in the Southport, Knowlsey, Liverpool and Wirral area.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

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's needs were assessed and recorded by suitably qualified and experienced staff. Support was delivered in line with current legislation and best practice. Risk assessments and support plans had been completed for everyone who was receiving care to help ensure people's needs were met and to protect people from the risk of harm.

People's preferences had been recorded in respect of personal care routines and likes and dislikes for food and drinks. Allergies and other medical information was also recorded.

Staff had been appropriately checked when they were recruited to ensure they were suitable to work with vulnerable adults. The service ensured that staff were trained to a high standard in appropriate subjects. Staff understood how to recognise abuse and how to report concerns or allegations.

The records we saw indicated that medicines were administered correctly and were subject to regular audit.

There were appropriate numbers of staff employed to meet the needs of people who received a service and to ensure they received the support at a time when they needed it.

Policies and procedures provided guidance to staff regarding expectations and performance. Staff were clear about the need to support people's rights and needs regarding equality and diversity.

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. We saw clear evidence of staff working effectively to deliver positive outcomes for people. People we reviewed were receiving effective care and support. They gave positive feedback regarding staff support.

People told us that staff treated them with kindness and respect. Support was provided in accordance with people's assessed needs.

People using the service and staff were asked to share their views. These provided very positive responses regarding the support provided.

There was a complaints process. Complaints had been investigated and responded to in a professional and timely manner.

People spoke positively about the management of the service and the approachability of senior staff. There was clear management structure that supported staff. At the last inspection the registered manager and director were not aware of their responsibility to notify the Care Quality Commission of certain incidents. The registered manager has submitted notifications to meet this requirement.

Further information is in the detailed findings below.

365 Support Services is a domiciliary care agency based in Southport. The agency provides personal care and support to people with learning disabilities and mental health needs in their own homes and supported accommodation within Merseyside and Wirral. The manager in post was in the process of applying to be the registered manager with the Commission. 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 said they felt safe when being supported by the 365 Support Services staff.

Comprehensive risk management plans had been completed for everyone who was receiving support to help ensure people's needs were met and to protect people from the risk of harm. Staff understood how to recognise abuse and how to report concerns or allegations. There were processes in place to help make sure people were protected from the risk of abuse.

Medication was administered safely by suitably trained staff and was recorded correctly. People received their medication on time.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable people. There were appropriate numbers of staff employed to meet the needs of people who received a service and to ensure they received their support at a time when they needed it.

Staff had the necessary skills and knowledge to support people in the way they needed and had a good understanding of people's needs. They received training on a regular basis. Staff received regular support through monthly supervision, appraisals and regular staff meetings.

People were supported to maintain good health. Staff sought the input of health and social care professionals if people's needs changed.

People said staff were caring and kind and always treated them with respect and dignity.

People were involved in decision-making about their care and support needs and were involved in the writing and reviewing of assessments, risk management plans and support plans. Support plans were completed to identify people's needs and the support required. We found people's preferences had been recorded to ensure person centred care and support was provided.

The service had a complaints procedure. People knew how to make a complaint and said they would feel comfortable raising a concern or complaint should it become necessary.

The service was not aware of incidents that required the Care Quality Commission (CQC) to be notified of. This meant that CQC were unable to monitor information and risks regarding the service.

The registered manager had left their position in January 2017. A new manager had been appointed and was in the process of applying for their registration with the Commission.

The management structure of the service had increased to meet the needs of the business. Managers were supported by a HR manager, an assistant, a quality assurance manager and a receptionist.

Quality assurance systems and processes were undertaken to monitor how the service was operating and to drive forward improvements.

Systems were in place to gather the views and opinions about the service from the people who received the service, staff and healthcare professionals. Questionnaires were sent out regularly throughout the year. Feedback was positive.

The ratings awarded at the last inspection were displayed in the office.

You can see what actions we have told the provider to take at the back of the full version of this report.