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Inspection carried out on 10 July 2019

During a routine inspection

About the service

Culmside Support LLP provides personal care and support to people with a learning disability living within a Supported Living environment. At the time of the inspection six people were being supported by the service. The service employed eight care staff.

The accommodation provided small three-bedroom units, with shared communal spaces. The provider’s office and staff room were not located within people’s homes, but in a separate building within the grounds of supported living accommodation.

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

People were supported to stay safe by staff trained to recognise and respond effectively to the risks of abuse. Potential risks to people’s health and well-being were identified and managed effectively in a way that promoted their independence. People were supported to take their medicines safely by trained staff. Sufficient numbers of staff were available to meet people's individual needs. Safe and effective recruitment practices were followed to help ensure all staff were suitable to do their jobs.

People were supported by staff that were well trained and received the appropriate support. People had their day to day health needs met with access to health and social care professionals when necessary. People were supported with a healthy balanced diet which met their needs. People were supported to have 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.

People were cared for in a kind and compassionate way by staff that knew them well and were familiar with their needs. People were involved in the planning, delivery and reviews of the care and support provided. People’s privacy and dignity was promoted.

People received personalised care that met their needs and took account of their preferences. People were supported to pursue a wide variety of social interests and take part in meaningful activities relevant to their needs and wishes. People and their relatives were confident to raise concerns.

People, their relatives, staff and professionals were all very positive about the registered manager and how the service was managed. Systems were in place to check the quality of the services provided; to manage risks and drive improvement. Staff understood their roles and responsibilities and felt well supported by the registered manager.

Rating at last inspection – Good (report published 24 January 2017)

Why we inspected

This was a scheduled/planned inspection based on previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 12 December 2016

During a routine inspection

Culmside Support LLP provides personal care and support to people with a learning disability living in their own homes in Uffculme, Devon. The service is a family business which currently provides personal care for people living within a Supported Living environment, which was also managed by the directors of the agency as a separate service. People had separate tenancy agreements and could choose which agency provided their personal care. Culmside Support LLP is not regulated to provide accommodation which meant we did not inspect the premises. The provider’s office and staff room were not located within people’s homes, but in a separate building within the grounds of supported living accommodation.

At the time of the inspection 3 people were being supported by the service. The service employed eight care staff.

This inspection was undertaken on 12 and 15 December 2016.

We last inspected the service on the 14 November 2013. At that inspection we found the provider was meeting all of the regulations we inspected.

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.

People received a safe service. People said they felt safe and comfortable with staff. Staff were friendly, kind and compassionate. Comments included, “I like all of the staff…”; “The staff are nice and kind to me…” and “I am very happy…” One relative said, “Yes, we know (the person) is absolutely safe. They (staff) have been splendid…” Another commented, “We are more than pleased with the service.”

There were safeguarding policies and procedures in place and staff were knowledgeable about the action they would take if they suspected people were at risk of harm or abuse. Risk had been identified and risk assessments were proportionate and included information for staff on how to reduce identified risks, whilst avoiding undue restriction. People’s medicines were managed safely and additional steps were taken during the inspection to ensure records were accurate and up-to-date.

There were sufficient staff on duty to meet people's needs in a timely manner and to support their preferred activities. Effective recruitment practices were in place to ensure new staff were suitable to work with the people using the service.

Staff received training relevant to their roles and had regular supervision meetings to discuss and review their development and performance. Relatives and healthcare professionals were positive about the skills, experience and abilities of staff.

The provider followed the Mental Capacity Act 2005 (MCA). People were supported to make decision in their best interests and staff had a good knowledge of the importance of seeking consent before providing care. People were supported to maintain good health and had access to health and social care professionals when necessary. Staff supported people to plan and prepare meals and maintain a balanced healthy diet.

Staff had developed positive and caring relationships with people and clearly knew them well. People were supported to be independent. They said they were able to do what they wanted and staff were supportive and encouraging of their independence. They were also supported and encouraged to take part in a wide range of activities within the local community and local day care services.

People were involved in the planning, delivery and reviews of the care and support provided. Where people had identified changes they would like, for example, the time of visits, or the gender of staff, this had been actioned.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. No complaints or conce

Inspection carried out on 14 November 2013

During a routine inspection

This was an unannounced inspection and the second inspection since registering with us in September 2011. At present the domiciliary care service is small, providing personal care and support to people within a Supported Living scheme. One person was currently receiving support with medication on a regular basis and another person had recently received temporary support with personal care and was now independent. We spoke with this person and spent time at the registered office talking with the provider and looking at some of their key documents. The person we spoke to who had received the service showed us their records that were kept in their home and told us they felt the care and support given by the service was �yes, very good� and met their needs in a caring way.

We saw that care and support was well planned and delivered effectively, with people being involved with assessing what their needs were and deciding how their care should be delivered. Where risks were identified, plans were in place to minimise those risks. The service referred health issues to appropriate health professionals and kept clear records to enable staff to understand how to deliver care in a person centred way.

The service had robust recruitment processes in place to ensure that people were safe and there were effective systems in place to reduce the risk and spread of infection.

We found that Culmside Support LLP was meeting all of the outcomes we inspected.

Inspection carried out on 25 January 2013

During a routine inspection

We carried out this unannounced inspection on 25 January 2013. The agency is a family business and was providing personal care for one person living within a Supported Living environment which was also managed by the directors of the agency as a separate service. We spoke with the provider, one care worker, the person receiving the service and looked at records.

We spoke with the person who used the service. We heard that they felt that the care and support given by the agency was �perfect for them� and met their needs. Comments included �I always know how to get help from someone and they help me properly with my medication, they are great!�

We saw that care and support was well planned, the person receiving the service had lived within the Supported Living setting for some years but had only recently required a personal care service from the agency due to their increased needs. They felt that they had been involved with deciding how their care should be delivered. Where risks were identified, plans were in place to minimise those risks.

We saw that the service had systems in place to support and train staff. These helped to protect people. Staff had training in the protection of vulnerable adults and understood what the processes were for reporting any concerns. This also helped to keep people safe. The provider carried out regular quality assurance visits in an informal way and completed care plan reviews to check that the person was happy with the service.