We carried out a review of the data available to us about Excellence Care 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 Excellence Care, you can give feedback on this service.
Excellence Care provides time-limited care and support for people with enduring mental health problems, complex needs and learning disabilities. People live in a large complex of individual flats in Basildon and in five shared houses across South Essex.
The majority of the people receiving a service from Excellence Care do not receive support with their 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. The organisation had increased in size since our last inspection. At the time of the inspection the service was providing personal care to 5 people at the service.
People’s experience of using this service and what we found
At the last inspection the service was rated as good overall with outstanding in well-led. At this inspection we found the service had continued to improve and the overall rating was now outstanding.
People’s needs and views were central to everything that happened at the service. People told us the service was somewhere they finally felt safe and respected. A person said, “Without them I don’t know where I would be.”
Professionals said this was a unique service, which had a vital role in supporting people to live independently and achieve positive outcomes. A health professional told us, “Credit where it is due. Too few services can or will provide this kind of care for adults with complex difficulties.”
The registered manager was an outstanding leader who inspired people and staff to reach their potential and have pride in their achievements. Their passion and commitment to excellence spread throughout the service ensuring it was continually evolving to reflect learning and best practice.
The service developed innovative and best practice strategies to support people safely. Staff had an enabling approach to managing risk and empowered people to be fully engaged in developing their own solutions. Staff took preventative action to support people’s mental health and enable them to continue living in their local community.
Staff had access to high quality, practical support and training and were exceptionally skilled and dedicated. Care plans contained detailed clinical advice outlining the support people needed. People’s voice was threaded throughout the plans. When they disagreed with professionals and staff their views were respected and promoted. Since our last inspection, new style care plans had been introduced to ensure information was given to people in ways they could understand.
Staff were focused on the wellbeing of the people they supported. They worked in close partnership with professionals to support people to remain healthy. People told us they particularly valued the support they received to help them stay out of hospital.
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.
Since our last inspection the service had been registered to provide support to people with learning disabilities. We found the service upheld the principles and values that underpin Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
Support was highly flexible and personalised, adjusting to people’s changing needs. Staff treated people with dignity, respecting their right to make choices. People developed lasting relationships at the service which they valued and maintained when they no longer received support from the service. The registered manager promoted opportunities for people to feedback about their support. This feedback was used to make the service better.
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, with well-led rated as outstanding. (published 25 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor this service and plan to inspect in line with our timetable for services rated outstanding.
Excellence Care provides personal care to people with mental health conditions in a supported living environment. At the time of the inspection there were 18 people living in a block of flats, which also contained office space and shared communal areas. There were an additional 10 people being supported in two local shared houses. The service does not provide nursing care. We were not inspecting the accommodation available which was managed by a separate organisation.
A registered manager was in post at 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.
The manager was an inspirational leader who passionately promoted best practice and continuous improvement. People were at the centre of the service and maintaining their wellbeing was the focus of the support provided. There were robust systems in place to check the quality of the service. People were aware of how to make a complaint and there were a number of opportunities available for them to give feedback and have input into the service they received.
People were supported to make safe choices and received advice from staff on how to minimise risk. There were sufficient numbers of skilled staff who were deployed flexibly and effectively to meet people’s changing needs. Staff supported people to take their prescribed medicines safely. The provider had a robust recruitment process in place to protect people from the risk of avoidable harm.
Staff were motivated in their role and worked very well as a team. The manager had developed innovative measures to support staff and develop their skills and knowledge. Staff worked with people to monitor their physical and mental health and what they ate and drank. The Registered Manager and staff communicated extremely well with outside professionals and supported people to access health and social care services when needed.
Staff worked within the Mental Capacity Act and understood about people’s right to make their own choices. Any restrictions to people’s freedom were discussed with them and mutually agreed with a view to minimising risks to their health and wellbeing. Staff knew people and were sensitive and responsive to their complex needs. They provided support which was unobtrusive and discreet.
People received support that was personalised and which was tailored flexibly to their changing needs. Staff worked with people to achieve jointly agreed objectives which enhanced their quality of life and maximised their independence.
Our inspection team was made up of one inspector. We spoke with three people who used the service, the manager, and three staff. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who used the service and with staff. We looked at three people's care records. Other records viewed included training records, health and safety checks, medication records, quality assurance audits and satisfaction questionnaires completed by the people who used the service, staff and health professionals who were involved with the people who used the service.
We considered our inspection findings to answer questions we always ask; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?
This is a summary of what we found;
Is the service safe?
We saw that records contained detailed assessments of people's needs that had been carried out prior to them moving to the service. Any training needed for staff to support people safely was identified and provided prior to the person moving to the service and if their health needs changed. This ensured that the staff had the relevant skills and knowledge to meet people's individual needs.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
We saw that all staff had completed refresher training in the last year for Mental Capacity Act 2005 and Deprivation of Liberties Safeguards.
Is the service effective?
People told us that they were happy with the care they received and felt their needs had been met. We saw and staff told us they understood people's care and support needs and that they knew the people well.
People's health and care needs were assessed with them. We saw people were involved in writing their plans of care and support. For example, we saw specialist dietary needs had been identified in care plans where required.
The training that staff had received equipped them to meet the needs of the people who used the service.
Is the service caring?
We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff showed patience and gave encouragement when people were supported. One person commented, 'The staff had helped them to settle into their flat, I couldn't get better staff.'
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
We saw monthly keyworker meetings took place where people had an opportunity to provide feedback on the service they received and review their progress against their individual goals and aspirations. People reviewed their goals and aspirations. For example, one person told us, 'I talked to staff about doing a basic counselling course; the staff supported me to identify one and make an application to attend.'
We saw health and social care professionals and the staff were encouraged to provide feedback about the quality of the service provided.
The service worked well with other agencies and services to make sure people received their care in a joined up way. We saw that a health care professional had stated in the quality assurance survey, 'That the general health and wellbeing of people who used the service is excellent.'
Is the service well led?
Staff told us they were clear about their roles and responsibilities and that they received excellent support and supervision from the manager. Staff had a good understanding of the aims and objectives of the service. This helped to ensure that people received a good quality service at all times.
The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service had been improved.