Archived: 10 Borough House

Life Path Trust limited provides personal care for people with learning disabilities. The service supports people in three supported living complexes in the Oxfordshire area. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. On the days of our inspection 15 were being supported by the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good overall.

Why the service is rated Good:

At our last inspection in June 2016 we found risks were not always managed safely. Some staff did not always follow guidance provided to keep people safe and the registered manager immediately took action to address the issue. At this inspection we found improvements had been made.

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking, which enabled people to live their lives as they chose. People received their medicines safely and were protected from the risks of infection.

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.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion and went the extra mile to provide support at a personal level. Staff knew people well, respected them as individuals and treated them with dignity whilst providing a high level of emotional support. People and their relatives, were fully involved in decisions about their care needs and the support they required to meet those individual needs.

People’s nutritional needs were met and staff supported people to maintain a healthy diet. Where people had specific dietary needs, these were met.

There was a positive culture at the service that valued people, relatives and staff and promoted a caring ethos that put people at the forefront of everything they did.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

People had access to information about their care and staff supported people in their preferred method of communication.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people.

Life Path Trust limited provides personal care for people with learning disabilities. The service supports people in three supported living complexes in the Oxfordshire area. In addition they also provide support for some people in their own homes. At the time of our inspection 12 people were using the service.

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.

The supported living complex atmosphere was open and friendly. The registered manager, area manager and staff were keen to show us their work and how they fostered a positive, open and honest culture.

Relatives told us people were safe. Staff understood their responsibilities in relation to safeguarding adults. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People benefitted from caring relationships with the staff. We saw many positive interactions where staff respected people’s privacy and promoted their dignity. People and their relatives were involved in their care and people’s independence was actively promoted.

People received their medicine as prescribed. Where risks to people had been identified risk assessments were in place and action had been taken to manage these risks. However, some staff had not always followed guidance to keep people safe from risks. We saw the registered manager had taken action to address these concerns.

There were sufficient staff to meet people’s needs. Staff rotas confirmed planned staffing levels were consistently maintained. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the Mental Capacity Act 2005 (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The operations manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People had enough to eat and drink. People could choose what to eat and drink and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

Relatives told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager. Staff supervision and other meetings were scheduled as were annual appraisals. Staff told us the registered manager and area manager were approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the registered manager and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

Below is a summary of what we found.

Is the service safe?

We found this service was safe. People felt safe with the support they received. We were told staff were skilled; trained and competent to be able to carry out their roles effectively. Staff demonstrated a good understanding of their responsibilities in relation to safeguarding.

Is the service effective?

We found the service to be effective. Care plans were detailed; personalised and focused on the independence and dignity of the person using the service. Staff told us they found the care plans informative and helped them understand people's needs. A relative told us the person using the service was "the happiest I have ever known him" and had great confidence in the staff. Care and support plans were written in a way to ensure people had opportunities to maximise their potential and achieve their wishes.

Is the service caring?

We found the service to be caring. We spoke with people who used the service, relatives, staff and managers. People were complimentary about the quality of the service and a relative described one staff member as "exceptional". Staff were motivated and described how they showed respect to people by offering choices and not making assumptions. Care plans were detailed and comprehensive and provided information to enable staff to deliver support in a consistent way.

Is the service responsive?

We found the service to be responsive. Staff told us they were flexible in their approach and support plans were often changed to meet the needs of the service users. We were told that managers were approachable and responsive. Relatives and staff felt able to raise any concerns with managers and were confident of a response and action.

Is the service well-led?

We found the service to be well-led. There were effective quality assurance processes in place to monitor quality and the provider responded positively to negative comments in order to improve quality for people using the service and their families.

We spoke with three care workers who said they enjoyed working with the people they cared for. One said "they are a blessing, they motivate me".

We found the care plans to be person centred, clear and up to date detailing appropriate care and treatment in a way that involved the person and helped to promote their independence. Risks were appropriately managed and care workers were correctly recruited, selected and trained. People were safe and well cared for.