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Archived: Sefton New Directions Limited - Home Service Good


Inspection carried out on 28 April 2016

During a routine inspection

Sefton New Directions provides three distinct services. A short term re-enablement service for people in their own homes, 'shared lives', a long-term domiciliary care service for people with learning difficulties and a supported living service for up to 15 people with learning difficulties in five tenancy locations.

This was an announced inspection which took place over three days on 28, 29 April and 6 May 2016. The inspection was carried out by an adult social care inspector.

The service had 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.

We saw that some of the medication administration records were not always clear in the supported living service so it was not clear whether people had received their medicines. There was a need to develop audits for checking medication standards to help ensure consistent safe standards were developed and maintained.

We told the provider to take action.

We were able to speak with people at the two supported living locations we visited. They looked relaxed and had an obvious positive rapport with the staff members providing support. Those able to express an opinion said they felt safe with the support they received.

We saw that people requiring support when out in the community to ensure they were safe, had fully developed plans in place. Staff were arranged to support this depending on each person’s needs. People’s support plans evidenced this.

We found staffing of the service was under regular review and there were sufficient staff available to support each of the three designated services within the Home Service.

We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. We looked at two staff files and found that appropriate applications, references and security [police] checks had been carried out. These checks had been made so that staff employed were ‘fit’ to work with people who might be vulnerable.

The staff we spoke with clearly described how they recognised abuse and the action they took to ensure actual or potential harm was reported. All of the staff we spoke with were clear about the need to report through any concerns they had. There had been a number of safeguarding referrals and investigations since our last inspection of the service. Agreed protocols had been followed in terms of investigating and ensuring any lessons had been learnt and effective action had been taken. This rigour helped ensure people were kept safe and their rights upheld.

Arrangements were in place for checking the care environment to ensure it was safe. There were protocols in place so that staff in all three services monitored the living environments and reported through any issues.

We observed staff provide support and the interactions we saw showed how staff communicated and supported people as individuals. Relatives told us that staff seemed well trained and competent. Communication between relatives, people being supported, staff and senior management was effective.

Staff were supported by on-going training, supervision, appraisal and staff meetings. Formal qualifications in care were offered to staff as part of their development. We saw there were plans to further develop training particularly with respect to the share lives service.

Local health care professionals, such as the person’s GP, and Community Mental Health Team were regularly involved with people. The feedback we received from people using the services, professionals and relatives evidenced good liaison and appropriate working to ensure people received good health care support.

Staff sought consent from people before providing support. When people w

Inspection carried out on 19 February 2014

During a routine inspection

We inspected the re-enablement element of this service. We spoke to people about this service and spent time observing people to gain a balanced overview of what people experienced and how they were cared for. We spoke to people using the service, and their relatives and members of staff.

We saw that staff knew the needs of people using the service. They worked with service users to create and review specific goals which were documented in each service users’ care plan. A service user told us that the carers had helped them to regain their confidence and that they were, “friendly and all lovely.”

We saw that staffing levels were always appropriate to meet the needs of the service users. We reviewed the training records for all staff and found that all staff received appropriate training to care for people using the service, and that it was updated regularly.

We saw that the service had a complaints policy. Details of how to complain were included in the care file for each service user. No written complaints had been made in the last two years. Issues or complaints raised verbally were documented and responded to appropriately.

Inspection carried out on 19 July 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from Sefton New Directions as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used postal surveys, telephone interviews and home visits to people who used the service and to their main carers (a relative or friends) to gain views about the service.

We were able to contact 21 people. People we spoke with made positive comments about the care and support they received from Sefton New Directions re-enablement services. They told us they understood the care and choices available to them and that they were involved in making decisions about the care and support they received.

Seventeen people told us that staff always asked them how they would like to be addressed when they first came into contact with them. They also told us as part of the initial assessment they were asked by care staff what they would like to be called. Some of their comments were: “It is nice to be called a name of our choice”; “I have a nick name and like to be used by everyone who knows me” and “I think it is dignified that staff ask us what we want to be called”.

We asked 21 people whether they had been given the choice as to the time they liked the visits to take place. They said that the timing of calls was prearranged and if they wanted to make changes they could do so by contacting the office or talking to the care workers.

One person said: “The staff call when they can and we appreciate that they have many people to call upon so don’t mind if they are a little late”.

Other comments included:

“Staff try to call at a time of our choice but it is not always possible.”

“Staff sometimes have to hurry to get their tasks done but I do understand they have lots more people to visit”.

People told us they felt at ease with the care staff. Comments included: “My main carer is exceptional but they are all nice really"; "I cannot

fault the way they treat me"; "Staff put me at my ease”; “Everything was explained by the carers before doing anything. Staff are always cheerful”.

We were told that people felt able to express their views and make choices about their care and support. Comments included: "My carers always ask me if everything is alright and ask me if I need anything changed”; “They adapt to suit me”; "My mother cannot really speak for herself but staff include me in all decision making about her care. I can see that she feels at ease and happy with the staff”; “Carers had time to talk which helped me after my operation” and “Staff are very open and get on with job in hand”.

Everybody we spoke with said they felt safe and fully supported by the care staff. Comments from people included: “Staff treat me like a real person”; “Staff are all very helpful and friendly. I will miss them when my re-enablement service ends, they all do a good job”; “The staff are able to tend to my needs and understand what care is required” and "The staff have enabled me to regain my independence by their good knowledge and kindness”.