During an assessment under our new approach
Date of assessment: 9 June to 20 June 2025. The service is a care at home service providing support to adults of all ages living with a range of different needs including dementia, physical disabilities and learning disabilities. At the time of the assessment, the service provided personal care and support to 99 people. We assessed the service because of age of the rating and the time since the last assessment. We looked at all 5 key questions and we assessed all of the quality statements in each of the key questions. This assessment included a site visit to the provider’s main office and offsite gathering and review of evidence. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities most people take for granted.
There was a learning culture in the organisation. Accidents and incidents were reported appropriately and information was analysed and reviewed to identify lessons learned. The provider made sure there was continuity of care, including when people moved between different services. The provider made appropriate referrals to the local safeguarding adults team to keep people safe and people’s capacity to make decisions was assessed in line with the Mental Capacity Act 2005. Risks associated with people’s care and support needs were assessed and mitigated appropriately. These risk assessments were reviewed regularly. The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Members of staff confirmed they had access to personal protective equipment (PPE) and they knew how to use it appropriately. Administration of medication was managed safely and people were supported to take their medications safely.
People's care plans were detailed and comprehensive and their needs were clearly assessed and identified. Care was delivered in line with care plans. Members of staff provided care and support which was in line with good practice guidance and standards. There were good relationships and communication with local health and care professionals which ensured care and support was joined up and met people's needs. The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People were asked to give feedback about how their care was provided to make sure it met their expectations. Members of staff confirmed they asked people for consent before providing personal care and support.
Members of staff treated people with kindness, empathy and compassion and respected their privacy and dignity. People's care plans were personalised and specific to them. Members of staff understood how to treat people as individuals and provided care and support in line with their needs and preferences. People were encouraged to maintain their independence. Family members described how the provider had responded proactively when their relative’s needs changed. We saw examples where calls had been flexible to accommodate a change of need. The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.
The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. The provider made referrals to community-based health and care services to ensure people's changing health needs were being met. People had access to a service user guide which gave contact numbers and clear answers to commonly asked questions and scenarios. Members of staff involved people in decisions about their care and told them what had changed as a result. People and their family members knew how to seek advice or raise concerns and felt confident to do so. People received care and support at the times which were convenient for them and members of staff were flexible and accommodated changes when people made requests. The provider supported people to maintain healthy relationships with family and friends and members of staff worked with them to maintain these links. There were arrangements in place to gather information about people’s individual needs, especially their preferences for the support they would like in the future.
The provider had a clear vision for the service which focussed on person-centred care and support. Leaders had the skills, knowledge, experience and credibility to lead effectively. Members of staff felt supported by the management team and confirmed they received supervision and support sessions. Regular team meetings supported and promoted workforce equality, diversity and inclusion. A comprehensives system of quality checks, audits and reviews was in place which enabled the registered manager to monitor and review performance and quality across the service. The registered manager acknowledged the importance of working in partnership with others to ensure people received consistently goof quality care and support. The registered manager demonstrated a good understanding of using feedback and lessons learned to support continuous improvement and development of the service.