We carried out a review of the data available to us about i-grow Care and Support on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about i-grow Care and Support, you can give feedback on this service.
At the time of the inspection 17 people were receiving support with personal care and lived within Plymouth and surrounding areas. Some of these people received care and support on a 24-hour, seven day a week basis. Others received support at particular times of the day when needed.
People’s experience of using this service and what we found
We received mixed feedback from staff regarding the quality of training, communication and support. The registered manager told us they were aware of some of the issues raised by staff and said some areas of training and support had been affected by the COVID-19 pandemic. A staff survey had been completed and an action plan was in place to address issues raised. This included reintroducing weekly calls to staff and face-to-face visits to provide support. It was too early for us to see the impact of these improvements.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right care, Right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, Right care, Right culture. People received a service that was personalised and took their specific choices into account. The management team and staff worked with people and their families from the point of referral to develop a plan of care that met their needs and desired outcomes. Some people had been supported to move into their own home where they had been able to make choices for the first time about their care and lifestyle. People had been supported to access work opportunities, develop new friendships and plan holidays of their choice.
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.
Other agencies told us they felt the service was well-led and provided personalised care that provided good outcomes for people.
The positive and friendly interactions we observed between people and staff indicated people felt safe and comfortable in their home Robust recruitment practices ensured the right staff were available to support people safely.
People were supported by staff to keep healthy and well. People’s care plans set out how staff should support them to manage their health and staff supported people to access health services when required. People were supported to take their medicines safely, in a way that suited them.
Regular audits were carried out with action plans and timescales for improvement.
We have made recommendations in relation to training, support and complaints.
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 (Published 23 February 2018)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.
disability as well as people living with sensory impairment and mental health needs. The service
supports some people on a 24 hour basis and others who may require support with personal care needs at specific times of the day and/or night. At the time of this inspection ten people received support with their personal care needs from the agency.
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
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Why the service is rated Good.
People told us the service they received was safe. A person explained how pleased they had been to write their own support plan. They said, “I was able to tell the staff the things that are important to me, and the things that make me feel safe.” A relative told us, “They’ve listened. They followed everything I have said. They make sure it’s the right staff for her.”
Safe and thorough recruitment procedures were followed before new staff were confirmed in post. People who used the service were involved and consulted in each stage of the recruitment process. There was a low staff turnover and this meant people received a consistent service from staff they knew and trusted. There were enough staff to meet people’s needs safely.
Staff had received safeguarding training and were confident they knew how to recognise and report any safeguarding concerns. Where staff supported people to manage their finances, amounts of money spent on the person’s behalf were carefully recorded and balances maintained and checked. Medicines were administered and recorded safely.
People received a reliable service from staff they had chosen. Effective planning systems were in place to plan staff rotas. People were given a timetable letting them know who would be supporting them each week. This meant people knew which care workers would be visiting and the times of each visit. People told us they never experienced a missed visit. Staff were flexible and willing to provide support at times to suit each person. A person told us, “They are so helpful to me.”
Staff were well trained, well supported and happy in their work. A member of staff told us their recruitment and induction had been, “Amazing. Fabulous.” Staff were flexible and willing to provide support to people at times to suit the person. Staff worked closely with relatives and professionals to make sure people’s health and personal care needs were well met. Staff knew what foods people liked and disliked and foods they were unable to eat. People were supported to plan and cook healthy meals of the person’s choice. Staff understood each person’s ability and rights to make choices and decisions. Families were involved and consulted appropriately.
People continued to receive a service that was caring. People and relatives praised the staff team for their caring manner. Staff were cheerful, friendly and positive. Staff knew each person well and displayed patience, kindness and understanding. Staff understood the importance of treating each person equally, and as an adult and a valued individual. A person told us, “They are really friendly.” They went on to say, “They are there for me. They are really good at picking me up. My carers know me very well. They pitch it just right.” A relative praised the staff team and told us, “They go the extra mile.” Another relative told us, “They have a very gentle approach and are very consistent.”
People continued to receive a service that was responsive to their changing needs. Before the provider agreed to provide a service they met with the person and their family and representatives to assess the person’s needs. People were involved and consulted in drawing up a plan of their support needs. The support plans were easy to read and contained sufficient information on each person’s daily routines and how they wanted to be supported. Relatives told us people’s lives had been transformed since they began receiving support from I grow. We heard examples of how people had become much calmer and happier.
People were enabled and supported to lead fulfilling, independent and active lives. People were supported to reach their goals and ambitions. People and their relatives were confident they knew how to raise a complaint and confident any concerns would be listened to and acted upon. We heard examples of people going on holidays, going to concerts and theatre events, and participating in a range of outdoor activities.
Information was provided to people in a format suitable for their individual needs. Throughout the inspection we saw evidence of how the provider and staff understood and promoted people’s rights as equals regardless of their disabilities, backgrounds or beliefs.
People continued to receive a service that was well-led. The provider had systems in place to monitor, assess and improve the service. There was an open culture, and people, relatives and staff said they found access to the office and management team welcoming and easy. Staff were positive and happy in their jobs. There was a clear organisational structure in place.
People, families and staff were involved in every aspect of the service. Their views were sought, and their ideas and suggestions welcomed and acted upon where possible. A relative told us, “They do listen to us.” The provider worked closely with other organisations to ensure the service met current legislation and good practice recommendations.
Further information is in the detailed findings below
i-grow Care and Support is a domiciliary care service that provides care and support to adults of all ages in their own homes. The service provides help with people’s personal care needs in Plymouth and surrounding areas. This includes people who may have a learning or physical disability as well as people living with sensory impairment and mental health needs. The service supports some people on a 24 hour basis and others who may require support with personal care needs at specific times of the day and/or night.
At the time of the inspection three people were receiving support with personal care needs.
There was a registered manager in post who was responsible for the day to day running of the service. 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 carried out this inspection on the 4 and 5 August 2015; we told the provider 24 hours before the inspection that we would be coming. This was to ensure the registered manager was available when we visited the agency’s office and so we could arrange to visit some people in their own homes to hear about their experiences of the service. This was the first inspection since the service was registered.
People told us they felt safe using the service. Comments included “I feel safe, staff know how to support me, if I didn’t feel safe I would know what to do and who to tell”. Relatives told us “I don’t feel I have to worry I can sleep at night”. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.
There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. The recruitment process of new staff was robust and people who used the service were involved when possible in the interview process. The requirements of an individual’s support team were detailed as part of their support plan and this information was used to match the correct staff to people who used the service.
People received support from staff who knew them well, and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. Comments included, “The best care I have ever had” and “The staff understand how I want and need to be supported. A relative said “The staff understand the guidelines about how to support [...] and they make sure they follow them.
The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
There was a positive culture within the service. The provider/registered manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared by the whole staff team. The registered manager said part of the recruitment process was to ensure any new staff would fit in and understand the values of the service. The registered manager told us, “We tell new staff about the culture, value of the service at the point of recruitment, we make sure they understand they are here solely for the people they support”. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they cared for people. Staff talked about ‘personalised care’ and ‘promoting independence’ and had a clear aim about improving people’s lives and opportunities.
There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post who had overall responsibility for the service. They were supported by other senior staff who had designated management responsibilities. People told us they knew who to speak to in the office and had confidence in the management and staff team.
Information was used to aid learning and drive improvement across the service. We saw accident and incident forms had been completed in good detail and included a process for staff to consider any learning or practice issues. The manager and staff monitored the quality of the service by regularly by undertaking a range of regular audits and speaking with people to ensure they were happy with the service they received. People and their relatives told us the management team were approachable and included them in discussions about their care and the running of the service.