Mencap North East (Durham, Gateshead, Darlington, Northumberland South and South Tyneside) is regulated to provide personal care and support to adults with learning disabilities living in their own homes. Some people lived in their own individual home and some in ‘supported living’ settings, so that they could 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 Mencap 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. At the time of inspection there were 60 people using the service.
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.
There were two registered managers in place who had worked together for over ten years and demonstrated strong oversight of the service. 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 were protected from harm by staff who were aware of the risks they face. These risks were individualised, well documented and assessed, with clear preventative plans in place.
There were no concerns regarding the safety of the service raised by relatives or external professionals. Clear protocols were in place for when staff encountered problems out of hours or when a support visit was missed.
Medicines and finances were managed safely, with all staff receiving appropriate training and annual competency assessments, as well as audits by the provider’s quality assurance team.
Specific training was implemented as a result of national audits which identified areas where people who used the service may be at particular risk, for example choking.
Where incidents or accidents occurred, the registered managers ensured lessons were learned and appropriate action taken to improve the service in future.
All staff were passionate about people who used the service getting access to the health care they needed and achieving outstanding quality of life outcomes. People who used the service and their relatives provided unanimously exceptional feedback about how staff helped them stay healthy. We saw consistent evidence of significant improvements in people's health and wellbeing thanks to the support of staff.
Technology was embraced to ensure people and their relatives could play as full a role in the planning and delivery of their care as possible. Outcomes included relatives abroad being involved in weekly discussions, where previously they had felt isolated, and people using devices that enabled them to more fully engage in conversations.
People’s nutrition was prioritised by staff who regularly found inventive ways to ensure people could improve their health and wellbeing through healthy eating. People who wanted to lose weight had done so and people who were at risk of malnutrition were supported successfully to regain weight. Where people had particular religious beliefs in relation to food, staff spent additional time becoming knowledgeable in this area to ensure they were respectful at all times.
Staff were extremely well supported by way of a comprehensive array of training the provider considered mandatory as well as regular supervision meetings with the line manager. The registered managers embraced new training which was based on recognised best practice.
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 support this practice. Best interest decision making adhered to the Mental Capacity Act 2005 (MCA) code of practice and the need for consent was embedded in the culture. Staff used the principles of the MCA to ensure people’s best interests were supported fully and without restriction. We found these assessments have been completed to a high standard and were extremely person-centred.
People received support from familiar and consistent staff they had built strong relationships with. People who used the service and relatives consistently praised the caring and positive attitudes of staff.
Staff respected people’s religious and cultural beliefs and valued their individuality.
People were supported and encouraged to pursue a range of activities meaningful to them. Staff were proactive in supporting people to socialise more and achieve goals such as trying new sports and attending further education.
Reviews, surveys and tenant meetings were in place to ensure people who used the service had a voice in the planning and delivery of their care.
Care files were detailed and, whilst on occasion needed updating in relation to people’s planned goals and achievements, were person-centred.
Complaints procedures were easily accessible and all people who used the service and their relatives knew how to raise concerns.
The registered managers led the service well, ensuring staff were well equipped to provide high standards of care to people. The provider had in place a range of national auditing and training frameworks, which the registered managers accessed for the benefit of staff and, ultimately, people who used the service.
Local oversight of the service was strong with all staff praising immediate line managers and the registered managers. Morale was high and the culture was focussed on ensuring people could achieve outstanding health and wellbeing outcomes as independently as possible.
Further information is in the detailed findings below.