12 September 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was completed by one inspector.
Service and service type:
Pure Offices is registered to support people with their personal care. Pure Offices specialises in providing care and support for people who live with a learning disability, in their own homes and when out in the community. At the time of the inspection there were 10 people receiving support with their personal care.
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:
The office inspection took place on 14 May 2019 and was announced. We gave the service 48 hours’ notice of the inspection because some of the people using it could not consent to a home visit from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this.
We made telephone calls on 20 May 2019 and 07 June 2019 where we spoke with people using the service, their relatives, staff, health and social care professionals.
What we did:
We used information we held about the service which included notifications that they sent us to plan this inspection. We also used the completed Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, the provider had completed this 11 months previously and we therefore gave opportunities for them to update us throughout the inspection.
We used a range of different methods to help us understand people’s experiences. We spoke with four people who were supported in their own home and observed the support they received. Some people were unable to talk with us so we observed interactions between people and the staff. We also spoke with five relatives and one other person receiving care from the service to gain their feedback on the quality of care. We spoke with Healthwatch which is independent consumer champion that gathers and represents the views of the public about health and social care services in England. Additionally we spoke with health and social care professionals the service had worked with over the last year.
We spoke with three support workers, the registered manager and the head of care. We reviewed care plans for four people to check they were and accurate and up to date. We also looked at medicines administration records and reviewed systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement. These included accidents and incidents analysis, complaints management, meetings minutes and quality audits.
We used the Short Observational Framework for Inspection (SOFI) when we visited people in their home. SOFI is a way of observing care to help us to understand the experience of people who could not talk with us.
12 September 2019
About the service:
Pure Offices is registered to support people with their personal care. Pure Offices specialises in providing care and support for people who live with a learning disability, in their own home and when out in the community. At the time of the inspection there were 10 people receiving support with their personal care.
People’s experience of using this service:
People and relatives were extremely satisfied with the service people received and spoke highly of staff and the registered manager. A comment from a relative summed this up by saying, “Care has surpassed what we could have ever imagined!”
People who used the service were treated with compassion and kindness and their privacy and dignity respected. We observed staff supporting people safely in their own homes.
Relatives and a person using the service told us they felt staff provided safe and extremely effective care. Staff turnover was low which people and relatives valued. People were supported by a small team of staff that understood their needs.
We found robust systems, processes and practices were followed effectively to safeguard people from situations in which they may experience harm. Risks to people’s safety had been thoroughly assessed, monitored and managed so they were supported to stay safe while their freedom was respected.
People told us they received their medicines as prescribed and records reviewed confirmed this.
Safe recruitment practices were followed. Arrangements to prevent and control infection were in place.
Staff had received all the training required to support people safely. Staff received regular supervision and annual appraisals and were able to reflect on the care and support they delivered. Staff were able to access further training in addition to their mandatory training.
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
People had been involved in agreeing their care plans and participated in reviews of the care and support provided to them. People and family members said that staff always asked for consent when carrying out care and support tasks.
People were fully supported to live healthier lives by having on-going support to access suitable healthcare services.
People received personalised care that was exceptionally responsive to their needs. Care staff understood the importance of promoting equality and diversity by supporting people to make choices about their lives. Confidential information was kept private.
There was strong sense of leadership in the service that was open and inclusive. The registered persons focused on achieving positive outcomes for people and their staff.
People and relatives benefited from a robust professional management framework that helped care staff to understand their responsibilities so that risks and regulatory requirements were met.
The service encouraged regular feedback from people who used the service, relatives, care staff and professionals. Views were gathered through questionnaires, telephone conversations, regular face to face meetings at people’s home and at staff team meetings in the office.
No complaints had been received in the last 12 months. People were introduced to lay advocates if necessary.
Comprehensive quality checks had been completed to ensure people benefited from the service being able to quickly put problems right and to innovate so that people could consistently receive safe care.
Good team work was promoted and care staff were supported to speak out if they had any concerns about people not being treated in the right way. Staff were clear about the vision and values of the service. In addition, the registered persons worked in partnership with other agencies and stakeholders to support the development of joined-up care.
More information is available in the full report.
Rating at last inspection:
Good (report published April 2016)
Why we inspected:
This was a planned inspection based on the rating at the last inspection when we rated the service as good overall. At this inspection there had been further improvements which resulted in the service being rated outstanding overall.
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.