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Inspection carried out on 13 February 2020

During a routine inspection

About the service

New Key provides support to people in their own home. People using the service have learning disabilities and/or autism, or physical disabilities. 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. At the time of the inspection, four people were receiving support with personal care.

People’s experience of using this service and what we found

People received good, person centred support that met their needs. People were encouraged to be part of planning their own support and setting their goals. Care was reviewed regularly to ensure it continued to meet people’s needs.

People were safe and had built positive relationships with staff who supported them. There were sufficient numbers of staff to cover people’s care needs. Arrangements were in place to cover shifts in the event of unplanned absence. People received safe support with their medicines where this was required.

Staff understood people’s needs well and worked hard to support people towards their goals and aspirations. We heard many positive examples of how people had been supported in an inclusive and empowering way. Staff incorporated the advice and guidance of other health and social care professionals in to their support.

Staff were well supported and trained. They told us they felt valued and listened to and free to raise any issues or concerns.

People were supported to have maximum choice and control of 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 that 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 service was well led. A strong person centred culture had been established within the service. The provider was working at a national level to promote ways of funding care that empowered and provided choice for people receiving care.

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 10 August 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.

Inspection carried out on 4 July 2017

During a routine inspection

The inspection took place on 4 and 6 July 2017 and was an announced inspection. We gave 48 hours notice of our inspection because the provider supports people in their own homes and we needed to make sure there would be somebody available in the office to support our inspection.

New Key Bristol provides supported living for people with learning disabilities and autism. At the time of our inspection, three people using the service received support in line with the regulated activity ‘personal care’.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was 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.

New Key Bristol provided an effective service that fully recognised people’s rights in line with the Mental Capacity Act 2005 (MCA). Staff fully explored people’s ability to make decisions themselves and used creative ways to ensure people could engage in the process. This ensured people were kept at the centre of decision making and that their human rights were protected.

Staff had excellent working relationships with healthcare professionals. In one case, we were told New Key were working effectively with community health professionals to ensure a person’s care could be delivered at home rather than in hospital. This meant that the person was receiving care in a familiar environment in the least restrictive way possible.

Staff were very caring and patient with the people they supported and there were occasions when they went above and beyond the expectations of their role. This included for one person, a member of staff staying with them during an emergency admission to hospital until the early hours of the morning. This person experienced high levels of anxiety and so having a familiar member of staff by their side was important to their wellbeing.

The service ensured that people’s views were taken in to account in the running of the service. People were actively encouraged to attend ‘review evenings’, where their views and opinions were listened to. Attendance at this evening was encouraged through providing refreshments and a film showing following the meeting. People using the service were also involved in the recruitment of new staff.

People received safe support with their medicines. Checks were carried out to ensure staff were completing administration records accurately. There was clear information in people’s plans about the support they required with their medicines. There were sufficient staff to ensure people’s needs were met and that they had a stable team of staff supporting them. There were systems in place to ensure new staff were safe and suitable for their role.

The service was well-led. Staff were all enthusiastic and motivated in their work and spoke positively about the support they received. The service worked with partnership organisations in the adult social care sector.

Inspection carried out on 11 June 2015

During a routine inspection

This inspection took place on 11June 2015. The inspection was announced, which meant the provider knew we would be visiting. This was because we wanted to make sure the provider, or someone who could act on their behalf, would be available to support the inspection.

There was 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.

New Key Bristol provides care and support to people with learning disabilities in their own homes.

People received support which helped them stay safe. Risks to people were assessed and plans put in place to reduce these. However, people’s medicines were not always being managed in a safe way.

Staff had got to know people well and there was good information about the way people liked to be supported. One person told us staff “followed a plan”. Care and support plans were updated so they reflected people’s current needs.

People’s rights were protected because staff understood their responsibilities in relation to the Mental Capacity Act 2005.

People spoke positively about the staff and how they were being treated. Staff were described as “friendly people”.

Staff received training and supervision which helped them to do their jobs well. Checks were carried out on staff to confirm they were suitable to be working with people who used the service.

Overall, the service was well run and meeting people’s needs. There were procedures in place for checking the service and identifying where improvements were needed.

We found one breach of the regulations during our inspection. You can see what action we told the provider to take at the back of the full version of the report.

During a check to make sure that the improvements required had been made

The provider had taken steps to ensure that suitable systems were in place for assessing and monitoring the quality of the service. Appropriate records were being maintained and action plans produced when shortcomings were identified.

Inspection carried out on 18 October 2013

During a routine inspection

People who used the service received a range of support according to their individual needs. For a number of people, this included assistance with personal care. Our inspection looked at the arrangements being made for these people.

We found that people�s care needs were being met. A relative told us that the agency �did what was expected� and that the support staff worked well with them. Individual plans had been written which set out the care that had been agreed. The plans helped to ensure that staff supported people in a consistent way which met their individual needs. Support with medicines was included in the plans and guidance had been written so that staff knew how to manage this safely.

Staff told us that they felt supported in their role. We found that the arrangements being made for training and supervision had improved during the year. There was a detailed policy about quality assurance. However the action being taken and the records did not reflect the arrangements as described in the policy. There was a risk that standards were not being checked regularly and any shortcomings would not be followed up.