Archived: New Directions Specialist Support Services

About the service

New Directions Specialist Support Services is a domiciliary care agency. It provides the regulated activity 'personal care' to people with mental health needs, learning disabilities and physical disabilities living in their own homes and in supported living units. At the time of this inspection, 49 people were using the service.

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, the service supported 8 people who received personal care.

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

Right Support:

The approach used by the service maximised people’s choice, control and independence.

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. However, improvement was needed around legal authorisations where people’s freedom was restricted.

Systems were in place to monitor and ensure people received their medicines safely.

Risks in relation to people's care and welfare were thoroughly assessed. This meant staff had the right guidance to support people safely.

Staff supported people to make decisions following best practice in decision-making.

Staff enabled people to access specialist health and social care support in the community.

Right Care:

The service had enough appropriately skilled staff to meet people's needs and keep them safe.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it.

Staff promoted equality and diversity in their support for people.

People's care and support plans reflected their range of needs and this promoted their wellbeing and independence.

Right Culture:

The service evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Quality assurance systems helped the staff team to monitor the service they provided and promoted ongoing learning.

Staff knew and understood people well and were responsive to their individual needs. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 May 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 24 and 28 March 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Directions Specialist Support Services on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the requirements of the Mental Capacity Act (MCA).

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

New Directions Specialist Support Services is a domiciliary care agency. It provides the regulated activity ‘personal care’ to people living with mental health needs, learning disabilities and physical impairments living in their own homes or in supported living services. At the time of this inspection, 54 people were using the service.

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.

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

While quality monitoring systems were in place, they were not always effective as they had not identified issues which we identified during this inspection. We found issues around risk management, medicines and staff training which the service had not identified.

Staff told us they felt supported and completed required training at the start of their employment but did not receive all appropriate training, as applicable to their duties, regularly.

Risks associated with people’s care and health were identified and managed in a safe way. However, we found instances where risk assessments were not always consistent and lacked detail.

Appropriate measures were in place to prevent people from catching and spreading infections. Accident and incidents were recorded, and any lessons learnt were used as opportunities to improve the quality of service.

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.

Right support

The service supported people to have the maximum possible choice, control and independence. Staff supported people to make decisions following best practice in decision-making.

Staff communicated with people in ways that met their needs.

People were supported by staff to pursue their interests. Staff ensured people had the opportunity to engage in activities which they liked.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right care

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People were involved in making decisions about their care.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right culture

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people’s wishes, needs and rights at the heart of everything they did.

People and those important to them were involved in planning their care. The service enabled people and those important to them to worked with staff to develop the service. Staff valued and acted upon people’s views.

The service evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

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 the service under the previous provider was good, published on 1 November 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.