Supported Independence Domiciliary Service & Personal Assistance North

What life is like for people using this service:

• People receiving support from North Supported Housing and Domiciliary have their needs met by sufficient numbers of suitably trained staff. People told us staff were kind and caring towards them and knew them as individuals.

• People were supported to remain engaged in accessing meaningful activity of their choosing.

• People were provided with support to maintain good nutrition and eat a balanced diet.

• Whilst no one was at the end of their life, the service had sought people’s preferences at the end of their life where this was appropriate.

• The service worked well with other organisations to ensure people had joined up care. External healthcare professionals made positive comments about the service provided to people.

• People were supported to make and attend appointments with external healthcare professionals.

• People and their representatives were involved in the planning of their care and given opportunities to feedback on the service they received. People’s views were acted upon.

• There was a robust quality assurance system in place capable of identifying areas for improvement. An ongoing improvement plan was in place.

See more information in Detailed Findings below.

Rating at last inspection: Good. (Published 10 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service continued to demonstrate the characteristics of a good service.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.

This was an announced inspection. The provider was given up to 48 hours’ notice because the service provides care and support in people’s homes and we needed to be sure someone would be available at the time of our inspection.

At the time of the inspection the service provided care, including 24 hour support, to eight people living in two supported living accommodations, plus 41 people living in their own homes.

There were two registered managers in post to cover the two aspects of the service; supported living and domiciliary. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

Risks to people's safety were assessed and reviewed. There was a wide range of risk assessments relating to people’s safety, which included more diverse risks associated with accessing the community. For people receiving care at home, risk assessments could be broadened to include screening tools for people at risk of malnutrition and assessment of skin integrity.

Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

People had confidence in the staff that supported them. There were enough staff to provide care and to offer flexibility in the service. Staff received training to enable them to deliver effective care. They were supported in their roles by a system of supervision and appraisal.

There were formal recruitment procedures in place, which included Disclosure and Barring Service (DBS) checks, prior to people starting work in the service. Some staff files did not contain reference checks on previous employment history, but this was addressed promptly by the management team.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who used the service, their relatives, and people closely involved in their care were involved and consulted. People were always asked for their consent before staff assisted them with any tasks. Staff respected people's privacy and people were treated with respect and dignity.

Systems were in place to ensure people's medicines were managed in a safe way, and people received their medicines in a timely manner.

Staff supported people to prepare meals and to eat and drink if required. Where people could benefit from additional support, referrals were made to other healthcare professionals.

There was an open door policy and a positive culture in the service. Staff felt comfortable to approach the registered managers for advice and guidance and felt able to raise concerns or issues as necessary. They told us they were listened to and action was taken promptly when required.

The provider had an effective quality monitoring system to ensure standards of service were maintained and improved. People were asked for feedback on the quality of the service they received and they were provided with information on how to make a complaint.

During our inspection we spoke with two people who used the service. They told us about the care and support they received and things that they enjoyed doing. We observed how staff interacted with them ensuring that at all times they were able to make informed choices about day to day decisions as well as other longer term choices. They told us the care and support they received was very good. One person told us, "I love it here, I never want to leave."

People we spoke with told us that they felt safe and the care staff looked after them appropriately. We asked staff about forms that abuse can take and they clearly understood the different types of abuse and how they would report any instance they witnessed.

We looked at a range of records. These were securely stored but available to us and up to date.