Real Life Options - Yorkshire

Real life options- Yorkshire provide support to people with learning disabilities living in 7 supported living settings, so that they can live in their own home as independently as possible. The service also provides domiciliary care to people living in their own houses and flats. At the time of our inspection, 37 people were receiving a regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People's experience of using the service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People were supported in having choice and control over aspects of their lives, for example people living in supported living settings had personalised their bedrooms. Risks to people were recognised, assessed and managed safely. Systems were in place to protect people from abuse and improper treatment. People were encouraged to be as independent as possible.

Right Care

There was not always enough staff to support people. Staff were knowledgeable about the people they supported and had established good rapport however, the service relied on agency staff who did not always know the needs of people.

Right culture

Recent changes in management had improved the service. People were supported to regularly identify, or review, on-going individual aspirations and life goals. Management supported staff in improving practice.

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 (published 16 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and recommendations

We have identified breaches in relation to staffing and good governance at this inspection.

This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Real life options- Yorkshire on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was the first inspection carried out by the Care Quality Commission (CQC) for this provider at this address.

The service provides care and support to people with learning disabilities living in seven ‘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.

The service also provides a domiciliary care service. It provides personal care to people with learning disabilities living in their own houses in the community. It provides a service to younger adults.

Not everyone using the service 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 consider any wider social care provided. At the time of this inspection 24 people were receiving a service from this provider.

The service was divided into three teams and there was a manager for each team. Two of the three managers were registered managers. 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.

Overall, people and their relatives told us they or their family members felt safe using the service. One person told us they did not always feel safe due to the challenging behaviour of others who used the service. A relative also raised similar concerns on behalf of their family member. We raised this with the management team and a social care professional who provided assurances this was being addressed.

People received care which protected them from avoidable harm and abuse. Staff had received appropriate safeguarding training. Risk assessments had been developed when needed, to reduce the risk of harm occurring. People were protected by safe recruitment procedures which helped to make sure only staff suitable to work with vulnerable people were employed.

Systems for managing medicines safely were overall, effective. The management team responded swiftly to some issues we identified with medicines support to ensure safe medicines management. Staff were trained in medication administration and their competency was checked regularly.

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 people were asked to consent to the support they received. Staff had completed training on the Mental Capacity Act 2005 (MCA) and were able to discuss the importance of supporting people with their independence and choices. The management team and majority of staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were encouraged to eat a healthy, balanced diet of their choice. However, two people’s relatives thought more encouragement was needed. People had access to a range of healthcare professionals in order to meet their health needs.

Staff received appropriate training, supervision and appraisal to support them to carry out their roles. This included positive behaviour support (PBS) training. Staff spoke highly of the training they received. Staff said they felt well supported by a management team who were open and approachable.

Staff supported people with kindness and compassion. Staff knew people well, respected them as individuals and treated them with dignity. People and their relatives, were involved in decisions about their and their family member’s care needs and the support they required to meet those individual needs. There was a positive culture at the service that valued people, relatives and staff.

Care records were person-centred and contained all relevant information to enable staff to provide personalised care and support. Support plans and risk assessments were updated as people’s needs changed to ensure staff were fully aware of people’s needs. People were supported to pursue social interests relevant to their needs, wishes and interests.

There was an effective complaints procedure for people to raise their concerns. The majority of people were confident they would be listened to and action would be taken to resolve any complaints they had. Information on raising concerns was available in accessible formats.

The provider and management team monitored the quality of the service and looked for continuous improvement. Any outcomes and actions were recorded and these were reviewed for their effectiveness in improving the quality of the service. There were systems in place to make sure managers and staff learnt from any incidents such as accidents and incidents.

The provider worked effectively with external agencies and health and social care professionals to provide consistent care.