The Wilf Ward Family Trust Domiciliary Care Ryedale and Whitby

Inspection site visit activity started on 28 June and ended on 5 July 2018. At the time of our inspection, there were 22 people using the service.

At our last inspection we rated the service good. At this inspection we found the registered manager and staff team had developed the service in a number of areas to achieve an outstanding rating.

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.

The service was extremely person centred and staff were proactive in ensuring people were supported to live fulfilled and meaningful lives.

There was a range of excellent social opportunities for people which truly incorporate people, relatives and the community. As a result, people had a sense of belonging and recognised positive improvements this approach had made to their lives.

Staff had an innovative approach to supporting people to access healthcare they needed. Potential barriers were discussed and overcome using unique methods that were suitable for the individual. Staff were passionate about ensuring all professionals understood people’s needs, abilities and the visions and values of The Wilf Ward Family Trust.

People had blossomed as individuals and as a result of staff’s positive approach to any situation, people had been able to develop their skills, seek employment in the local community and build friendships within the local area.

Potential barrier to communication were addressed. People, staff and the community had been encouraged to participate in a Makaton choir to allow people to learn and use Makaton whilst building positive relationships. Staff and management had researched, visited and completed assessments with charities to help people gain access to communication and mobility aids to considerably improve their quality of life.

Staff understood the importance of maximising the opportunities for people and had an above and beyond approach to supporting people to live truly fulfilling lives.

Staff understood the importance of ensuring that not only did they understand people’s individual needs in relation to protected characteristic, values and beliefs but that people were given the opportunity to also learn about this which was presented in a way they could understand.

Staff were passionate about the people they supported. They shared their knowledge with other professionals to ensure people were consulted, empowered, listened to and valued as individuals.

The service was exceptionally well-led by a registered manager who led by example and had embedded an open and honest culture. Staff were committed to working at the service as the management team valued and invested in them.

Quality assurance systems were robust and used regularly by the management team to continuously improve the service. The registered manager had a thorough system in place to ensure lessons learnt were thoroughly embedded. The registered manager promoted accountability for all staff.

Continuous improvement was driven by engagement with people using the service and staff. The registered manager was keen to learn from best practice used in the other providers locations to ensure people received the best possible support and outcomes.

Staff were highly motivated and offered care and support that was exceptionally compassionate and kind. Respect for privacy and dignity was at the heart of the service's culture and values.

The registered manager demonstrated clear visions and values and was passionate and committed to providing an excellent person-centred service for people and their relatives. These values were owned by staff who were equally enthusiastic about fulfilling their roles and responsibilities in a way that delivered the best possible outcomes for people.

Safe recruitment processes had been followed. People who used the service were actively involved in the selections and interviewing of potential new staff. Staff were able to describe the different types of abuse and action they would take if they suspected abuse was taking place. Risks to people had been appropriately managed and recorded. There was enough staff on duty to support people safely. Consistency of staff enabled people to build positive relationships.

A thorough induction process was in place which incorporated the providers visions and values. Staff had been provided with training to ensure they had the skills and knowledge to support people safely. Staff received regular support and guidance from the management team and were encouraged to continuously develop within their role.

People were encouraged and supported to follow a healthy balanced diet. Peoples choices were respected and although living with other people, each person was treated as an individual. Staff understood the importance of ensuring people received regular health checks. Staff worked in partnership with other professionals to ensure people received the best possible care and support.

Staff displayed empathy and worked with people and their relatives to understand how best to support them. Potential barriers to communication were addressed through staff's in depth understanding of people's unique communication styles which were detailed in people's care records.

Activities were offered as a result of consultation with people and their relatives about their interests. Whilst there was a variety of group activities available, people also had ample opportunities to participate in activities that were of particular interest to them.

A complaints policy and procedure was in place and available in formats people could understand. People were confident and complaints would be addressed appropriately.

This is the first inspection of the service following the change to the domiciliary care registration so that there is one location for each geographical area which The Wilf Ward Family Trust (the Trust) covers.

The Wilf Ward Family Trust Domiciliary Care Ryedale and Whitby provides personal care and support to 26 people who are living in supported living services in the Ryedale area.

There is a registered manager. 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 found staff were recruited safely and in sufficient numbers to support the needs of people who used the service. Staff received training, supervision and support to enable them to have the skills and confidence to communicate with people and to promote their safety and wellbeing.

There was a policy and procedure to guide staff in how to safeguard people from the risk of harm and abuse. Staff had received safeguarding training and had followed local safeguarding protocols in practice.

Risk assessments were used to identify and minimise potential risks, whilst enabling people to be as independent as possible. People received their medicines as prescribed

We found people were supported to maintain their health and access a range of community health care professionals.

Staff supported people to plan their menus, shop for ingredients and prepare meals. We saw people had plenty to eat and drink and were able to make choices about their nutritional intake.

People could make choices and decisions about their lives. The registered provider had ensured staff received training in the Mental Capacity Act 2005 so that they were equipped to work within the law when people were assessed as lacking capacity.

Staff were knowledgeable about the people who used the service and were providing person-centred care. We saw that staff encouraged people to be independent both within the service or when they accessed community activities. People told us they liked the staff and we observed that people were at ease with each other and with staff. We saw that staff offered reassurance and were respectful to people and protected their privacy and confidentiality.

The culture and values of the organisation was to support people to live personalised lifestyles through a culture of participation, involvement and encouragement. We observed this occurred in practice during staff interactions with people who used the service.

Appropriate management systems and processes were in place to monitor the service and drive forward improvements.