Archived: Community Wessex - East

Community Wessex East is registered to provide personal care to people in their own homes. At the time of our inspection ten people with autism, learning disabilities and mental health needs were receiving 24 hour support with personal care in their own 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 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 people we met during our inspection were unable to communicate verbally, however parents and support staff told us people expressed they were happy and more settled in their homes. Relatives told us they felt people were safe and the service provided good care and support.

We have made two recommendations, the first is to ensure the provider maintains effective oversight and management of the service. The second recommendation is for the provider to ensure resulting action and outcomes from quality assurance questionnaires are captured.

The provider had robust recruitment systems to ensure staff were safely recruited. Staff spoke knowledgably about the systems in place to safeguard people from abuse.

Risks had been identified and measures put in place to keep people safe from harm. People received their medicines as prescribed and were supported to access health care services as required. Medicines were stored securely, managed safely and administered by trained staff who had regular checks to ensure they were competent to administer medicines.

People were supported by a core team of staff who knew their individual needs and preferences well. Staff provided kind, caring and safe care and support to people, treating people as individuals with respect and dignity.

Staff had received effective training which they said was well delivered and ensured they remained up to date with all core areas. Specific training needs, such as epilepsy and autism awareness were available, and staff felt well supported and were encouraged to develop within their roles.

Staff received regular supervision and annual appraisals to ensure they were fully supported in their role.

The service was working within the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control over 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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The service used positive behaviour support principles to support people in the least restrictive way.

People's care was tailored to their individual needs and maintained their independence as much as possible. Care plans were comprehensive, person centred, respectful, and reviewed regularly to ensure they reflected people’s needs.

People were supported to lead active lives and took part in a range of different activities if they wished. People who preferred to spend time on a one to one basis were supported with appropriate activities they enjoyed, to ensure their wellbeing was maintained and to prevent social isolation.

There was a system of ongoing monitoring through audits and spot checks to review the quality of the service provided. There was an ethos of continual learning with an open, approachable and supportive culture in place. Staff felt listened to and supported in all areas of their work.

Relatives and staff expressed confidence in the management team and felt the service had a clear management structure and an open and supportive culture.

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 3 July 2017).

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.

Community Wessex - East delivers domiciliary personal care to people with learning disabilities, and autism. Personal care was provided to 30 people who lived in their own homes. There was a central office base which had a reception area, four offices and a training room.

The service had a registered manager 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.

People’s review meetings and quality monitoring systems were not set up to capture people’s feedback, views and opinions based on their progress in achieving goals and experience of the quality of care they received. We were told that these systems would be reviewed to capture actions, outcomes and feedback.

Medicines were managed safely, in people’s homes, correctly recorded and only administered by staff that were trained to give medicines. Medicine Administration Records reviewed showed no gaps. However, we found that medicine cabinets were not secured to the walls. This was rectified on day two of our inspection.

Relatives, health and social care professionals and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training.

Personalised care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had a care file which also included outcomes and guidelines to make sure staff supported people in a way they preferred. Risk assessments were completed, regularly reviewed and up to date.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, autism and epilepsy.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. People’s records contained assessments of their capacity. Where decisions had been made in people’s best interests around their care and treatment these were being recorded fully. This made sure that any decisions made were in people’s best interests and were least restrictive as possible.

Staff told us they received regular supervisions which were carried out by management. We reviewed records which confirmed this. A staff member told us, “I receive regular supervisions and find them useful”.

People were supported with shopping, cooking and preparation of meals in their home. Menus were created based on people’s likes and reflected a good variety of meals to maintain healthy diets.

People were supported to access healthcare appointments as and when required and staff followed GP and community nurses’ advice when supporting people with ongoing care needs.

Relatives and health and social care professionals told us that staff were caring. During home visits we observed positive interactions between staff and people. This showed us that people felt comfortable with staff supporting them.

Staff treated people in a dignified manner. Staff had a good understanding of people’s likes, dislikes, interests and communication needs. Information was available in various easy read and pictorial formats. This meant that people were supported by staff who knew them well.

People had their care and support needs assessed before using the service and care packages reflected needs identified in these. We saw that plans were regularly reviewed by the service with people (where possible), families and health professionals when available.

People, staff and relatives were encouraged to feedback. We reviewed the findings from quality feedback questionnaires which had been sent to people and noted that it contained mostly positive feedback. However feedback surveys had only been created in a text format. We were told that these would be reviewed so that people with specific communication needs could be more included in these.

There was an active system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints in place. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.

Staff had a good understanding of their roles and responsibilities. Information was shared with staff so that they had a good understanding of what was expected from them.

Relatives, health and social care professionals and staff felt that the service was well led. The management team and chief executive officer encouraged an open working environment. People and staff alike were valued and worked within an organisation which ensured a positive culture was well established and inclusive. All the deputy managers had good relationships with people and delivered support hours to them.

The service understood its reporting responsibilities to CQC and other regulatory bodies and provided information in a timely way.