Kings Dock Mill

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.

At this inspection we found the service remained Good.

People we spoke with told us that staff supported them when they needed it. We saw through people's body language and chatter between them and staff that they were comfortable with the staff supporting them.

There were robust measures in place to ensure people were safe. Staff had received training in safeguarding adults from abuse and knew what to do if they saw or suspected abuse. Risk assessments were in place specific to their individual needs.

The service completed a number of robust safety and maintenance checks for the people they supported at Kings Dock Mill. These included, medicines, fire safety and water temperatures.

Sufficient staff were available to meet people's needs. Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. We found that staff had the skills, knowledge and experience to support people effectively and safely.

Staff were supported by the manager through regular supervisions and regular training. Staff meetings were held regularly.

Medicines were managed safely; people received support with their medicines as required. Staff had been trained to administer medicines; staff competency to safely administer medicines was checked regularly by the registered manager.

Regular checks and tests, such as gas, electricity, water safety and for fire safety were completed to maintain safety in the people’s homes.

People's needs were assessed and reviewed regularly to reflect people's current health and support needs. Appointments were made regularly with, for example, the GP and dentist, to help to maintain good health.

People were supported to shop for food and prepare meals in accordance with their support plans. Some people were supported to eat and drink to maintain a balanced diet.

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. People made decisions and choices in relation to their care, support received, daily routines and any activities they wished to take part in.

People received personalised care that was responsive to their needs. Person centred plans (PCPs) were written for the individual and informed staff of their preferences and wishes. We found they contained detailed information that enabled staff to meet people's needs. Support plans were completed to show the goals people wanted to achieve.

Staff knew the people well and how they communicated their needs and choices, including their preferred daily routine.

There was a complaints policy in place. However no complaints had been received. People we spoke with said they knew how to complain if they had a problem but said they were very happy with the service they received.

There was a person-centred culture in the organisation. Staff showed a commitment to provide support for the people to be able to live in their own home.

Quality assurance audits were completed by support staff and the registered manager which included, medication and health and safety checks.

There was a process completed annually where people had the opportunity to voice their opinions about the service. Feedback we saw was positive and complimentary.

There was a registered manager at the service. They were supported by a deputy manager, team leader and support workers.

The registered manager and registered provider met their legal requirements with the Care Quality Commission (CQC). They had submitted notifications and the ratings from the last inspection were clearly displayed in the office.

Further information is in the detailed findings below.

Kings Dock Mill is registered to provide personal care to seven people living in their own homes. People who use the service are provided with a range of hours of support per day in line with their assessed needs. The office base is located within the Kings Dock Mill complex. People who use the service have access to out-of-hours emergency support .

A registered manager was 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 people that we spoke with had no concerns about the safety of services. The provider had delivered an extensive training programme for staff and managers regarding adult safeguarding. The staff that we spoke with confirmed that they had attended the training and were able to explain the different types of abuse and what action they would take if they were concerned that abuse or neglect were taking place.

The care records that we saw showed clear evidence that risk had been assessed and reviewed regularly. Risk was reviewed by staff with the involvement of the person or their relative and maintained a focus on positive risk taking to support independence.

Incidents and accidents were recorded electronically and subject to a formal review process which included an analysis that was shared with senior managers.

Staff were recruited following a process which included individual interviews and shadow shifts. Each offer of employment was made subject to the receipt of two satisfactory references and a Disclosure and Barring Service (DBS) check.

Staff were trained in the administration of medicines but because the services were community-based, they were not always responsible for storage and administration. Some people who used the service were able to self-administer their medication, others required prompting. Medication Administration Record (MAR) sheets were completed by staff where appropriate. The records that we saw had been completed and showed no errors or omissions.

Staff had been recruited and trained to ensure that they had the right skills and experience to meet people’s needs. Staff were required to complete an induction programme which was aligned to the Care Certificate.

Staff were trained in a range of subjects which were relevant to the needs of the people using the service. We looked at records relating to training and saw that all training had been refreshed in accordance with the service’s schedule. People using the service and their relatives said that staff had the right skills and knowledge to meet people’s needs.

People’s day to day health needs were met by the service in collaboration with families and healthcare professionals. Staff supported people at healthcare appointments and used information to update support plans. We saw evidence in care records that staff supported people to engage with community and specialist healthcare organisations to support their wellbeing.

We had limited opportunities to observe staff providing support during the inspection. Where we did observe support we saw that staff demonstrated care, kindness and warmth in their interactions with people. People told us that they very were happy with the care and support provided.

People were supported by the same staff on a regular basis and each person had a nominated keyworker. When new staff were being introduced they were required to work along-side a more experienced colleague on ‘shadow-shifts’. This gave people the opportunity to assess whether they wanted the new staff member to be part of their support team.

We saw that staff knew the people that they supported well. When we spoke with them they described the person and their needs in detailed, positive terms. Staff told us that they enjoyed providing support to people and were able to explain how they involved people in making decisions about their day-to-day care and support.

The provider made use of person-centred planning techniques to maximise the involvement of people in the planning process. We saw that the person-centred plans (PCP’s) were produced to a very high standard with words and pictures to aid understanding. The plans had been further personalised by the use of different fonts and coloured paper to reflect people’s preferences.

We saw from care records and PCP’s that people were given choice over each aspect of their service. This choice included; staff, activities and times of support.

The provider encouraged people and their families to provide feedback through a range of formal and informal mechanisms. They issued regular surveys and sought feedback at each review. People and their relatives told us that they fed-back to the registered manager, team leader and other staff on a day-to-day basis.

The staff that we spoke with were motivated to provide high quality care and understood what was expected of them. They spoke with enthusiasm about the people that they supported and their job roles. Each of the staff was positive about the support and quality of care offered by the organisation.

The registered manager and staff were clearly aware of the day to day culture and issues within the service. We saw that they knew the people using the service and their staff well. The registered manager understood their responsibilities in relation to their registration. Notifications relating to people who used the service had been submitted to the commission as required.

The registered manager was available to members of the staff team throughout the inspection and offered guidance and support appropriately. The manager had sufficient systems and resources available to them to monitor quality and drive improvement.

The registered manager and other senior managers had completed a series of quality and safety audits on a regular basis. Important information was captured electronically and used to produce reports. These reports were shared with senior managers throughout the organisation and used at a local level to monitor and drive improvement.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We spoke with two people who used the service at Kings Dock Mill and they told us they felt safe and well supported. Policies and procedures were in place which helped ensure any unsafe practice was identified and people were kept safe.

People who used the service were not subject to any unnecessary risks. We saw that people were included in planning their care which helped ensure they had choices related to their support.

Is the service effective?

People who used the service had their care needs assessed with them, and when possible, their families. We looked at six care plans and saw that they were up to date and contained relevant information.

We spoke with two people who used the service and one told us, "The staff are very supportive. They are very good at their job." It was clear from talking to staff members that they had a good understanding of the care and support needs of all people who used the service.

Is the service caring?

People who used the service had their wishes and preferences recorded and had their care and support provided in accordance with their individual wishes.

We spoke with two people who used the service and one told us, "The staff make me feel happy. I feel so safe here and the support is just great." We also spoke with three staff members and it was clear they genuinely cared for the people they supported.

Is the service responsive?

The day before our inspection, a `tenant`s meeting` had taken place. One of the people who used the service told us two requests had been forwarded to the manager following the meeting. We saw that both requests had been addressed in line with the requests which showed the provider had listened to, and responded to, people`s wishes.

We saw a complaints procedure was in place at Kings Dock Mill. People who used the service were aware of the process and had a copy of the complaints procedure in their flats. People also had access to a customer helpline if they preferred to use that.

Is the service well-led?

The provider had a quality assurance system in place which included both internal and external audits. This helped ensure any shortfalls were addressed and the service provided continued to improve.

The staff members we spoke to were clear about, and had a good understanding of, their roles and responsibilities. This showed staff had the skills and knowledge which helped meet people`s needs. This helped ensure people received a good quality of care and support at all times.

We spoke with relatives as part of our inspection. One relative told us that staff were punctual and reliable and the quality of the service was excellent. One person described staff as 'Brilliant' and said that they would feel confident to talk to staff if there was something they were not happy about. We also asked people who used the service if they felt confident to raise any concerns they had about their care and support. People told us they did and that they felt safe living at Kings Dock Mill.

The people who used the service were cared for by staff that were appropriately recruited, trained and experienced at supporting them.

The team leader told us that he was in regular contact with people who used the service and with their relatives. We found people were made aware of the complaints system.