Positive Steps Shropshire Limited

Updated 9 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Positive Steps Shropshire is a shared lives scheme, they recruit, train and support self-employed shared lives carers (SLC) who offer accommodation and support arrangements for vulnerable adults within their own family homes in the community. The service is also a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service short notice of the inspection. This was because we needed the service to make contact with the SLC and people that used the service to ask if we could speak or meet with them.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

We contacted visiting professionals by email to seek their views on the service provided.

During the inspection

During the inspection we spoke with three people who used the service, two relatives and three SLC. We also spoke with the registered manager, domiciliary care manager, two shared lives workers, the recruitment manager, two domiciliary support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with an advocate project worker.

We looked at a selection of records. This included four people's care records, risk assessments. and medicine records. We looked at one staff member's recruitment record and other records related to monitoring and the management of the service.

After the inspection

We spoke with six relatives/representatives of people who used the service. We continued to seek clarification from the management team to validate evidence found. We looked at training data, compliments and complaints, supervision and appraisal records and a variety of policies and procedures.

Updated 9 October 2019

About the service

Positive Steps Shropshire is a shared lives scheme which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. The service also provides domiciliary care. 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 53 people were living in long-term shared lives arrangements, and 44 people accessed shared lives for respite only. There were 26 people who received domiciliary care.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

We saw excellent examples of how people were supported to remain safe at times when they were at significant risk. The risk of abuse was minimised because there were clear processes, training and procedures in place to protect people. Staff and SLC were proactive and supported people to take positive risks, ensuring they had maximum choice and control of their lives.

The provider's robust recruitment processes for staff and SLC, along with the matching process, had exceptionally positive outcomes for people.

Medicines were managed safely. There was an open and transparent culture in relation to accidents and incidents and they were used as opportunities to learn and lessen risks.

Staff and SLC had exceptional skills and knowledge to deliver care and support in a person-centred way. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People's needs were met through robust assessments and support planning. We saw examples of when the service had worked with other professionals to achieve positive outcomes for people and to improve their quality of life.

People's privacy, dignity and independence was made a priority in supporting people in all areas of life. People could plan for their future, including their wishes at end of life.

People told us staff and SLC were exceptionally compassionate and kind. Staff and SLC expressed commitment to ensuring people received high-quality care. We heard excellent examples of how SLC ensured people felt part of their family. SLC and staff knew people exceptionally well. People were encouraged to learn new skills to enhance their independence.

We saw excellent examples of how the care and support people received enriched their lives through meaningful activities. The service was proactive in its response to concerns or complaints and people knew how to feedback their experiences.

The management team planned and promoted holistic, person-centred, high-quality care resulting in excellent outcomes for people. The values and culture embedded in the service ensured people were at the heart of the care and support they received. SLC and staff told us they received excellent support from management and staff told us they were extremely proud to work for the service. There was a very open and transparent culture and people were empowered to voice their opinions. Without exception, people told us the service was well-managed.

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 good (published 18 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.