Archived: Barnsley MBC Learning Disabilities-Domiciliary Care Team

Barnsley MBC Learning Disability Services is a supported living service which provides care and support for people with learning disabilities. Care is provided to people in their own homes via tenancy agreements. At the time of this inspection the service provided care to approximately 50 people, some of whom lived on their own, whilst others were accommodated in shared houses.

A registered manager was in place. 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.

People told us they felt safe when supported by staff employed by the service. All staff members had been trained in recognising the signs of potential abuse and how to respond. A safeguarding policy was in place and records showed staff had been proactive in referring any historic concerns to the local safeguarding team.

Risks had been assessed and re-evaluated regularly. People were encouraged and supported to be as independent as they could be, and risks related to independent living had been assessed and mitigating actions identified. Accidents and incidents had been monitored and measures put in place to reduce the likelihood of them reoccurring.

There were enough staff to meet people’s needs. Processes were in place to ensure any staff absences could be covered so people still received their scheduled visits. Robust recruitment procedures had been followed.

Staff had undertaken training in a range of subjects through both online e-learning and face to face practical training. Staff training was monitored to ensure any required updates or refresher training was received on time, so staff skills and knowledge remained up to date. Staff received additional training in relation to people’s specific needs, and their skills were assessed to determine if they were competent to deliver tasks safely.

Care Quality Commission (CQC) is required by law to monitor the application of the Mental Capacity Act 2005 (MCA), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. We found the provider was complying with their legal requirements. The manager and staff were able to describe how the principles of MCA were adhered to in daily practice.

People’s nutritional needs had been assessed and specific information provided about how to meet these needs. Food and fluid intake was monitored where necessary. Records showed people’s likes were taken into consideration and that people were involved in choosing and making their own food.

People we spoke with told us they were happy with the care they received. They told us care was planned around their choices and that staff listened to them.

People’s needs had been assessed and specific and detailed care plans had been created to ensure all staff had access to information about people’s needs.

People were encouraged to share their feedback. We saw very positive responses had been received following a survey of people and their relatives in September 2015. The results had been collated and analysed and the responses indicated people were satisfied with the care they received.

The service had received one complaint in the 12 months prior to our inspection and this complaint had been investigated and responded to appropriately and in line with the provider’s complaints policy.

People and their relative’s told us the service was managed very well. The manager shared with us their vision for the culture of the service, which was to develop people’s independence and enable them to enjoy full lives. All of the staff we spoke with told us they agreed this culture was in place.

Staff told us they felt listened to and valued. Staff meetings were held regularly. Their feedback had been sought through a staff survey.

A range of checks were carried out to monitor the quality of the service. Care records were maintained to a good standard and stored securely so they remained confidential.

The manager told us the service was due to cease operation in April 2017. Processes had been put in place to minimise disruption to people who used the service and staff during the transition to new providers.

We considered all the evidence against the outcomes we inspected to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There were risk assessments in place for people using the service in relation to their support and care provision. People were not put at unnecessary risk, had choice and remained in control of their own decisions. This meant peoples' independence was promoted and they were not restricted from engaging in, and accessing, the wider community.

Systems were in place to make sure managers and staff learned from events such as accidents, incidents, complaints and concerns. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Staff received training in the Mental Capacity Act 2005 (MCA) to ensure that where required, decisions made on behalf of people were in their best interests and in line with code of practice.

Recruitment practices were designed to ensure that new employees were safe and suitable to work with people who used the service.

Is the service effective?

Peoples' health and care needs were assessed with them and they were involved in compiling their own support plans. Information had been taken into account from other professionals and organisations which demonstrated a holistic approach was undertaken in providing support to people.

Staff received mandatory and specific training relevant to their role. They told us they felt supported by management and we saw regular supervisions and appraisals took place. Staff said they would be able to undertake further training if they wished to. This showed that staff had opportunities to progress and develop within their roles.

Is the service caring?

During our visit we saw support workers interacted positively and gave encouragement when supporting people. People using the service told us, 'I'm pleased with everything, I get on with them all [staff]', 'it's helped me with a lot of things, I'm getting on top of stuff', 'I like all the staff, they give me a little bit of help, encourage me to do things, happy with everything' and 'They're [staff] brilliant'.

People's preferences, interests, aspirations and diverse needs had been recorded in a person centred way and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People were supported and encouraged to complete activities they enjoyed and undertake tasks to promote their independence. One relative told us, 'my [family member] is absolutely better for using the service. I wish everyone had the opportunity, it's a dream come true. It's wonderful to know [my family member] is so well cared for and it means a lot'.

Everyone we spoke with told us they made their own choices and that staff supported them with their decisions.

People knew how to make a complaint if they were unhappy and said they would tell staff and would feel comfortable in doing so.

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way.

There were quality assurance processes in place which included monthly monitoring visits by senior staff. Feedback was sought by way of satisfaction surveys sent to people. The results of these surveys were analysed and the findings compiled in a report which was sent to people who used the service.

Staff were clear about their roles and responsibilities. Discussions on best practice, improved ways of working and knowledge sharing were common throughout formal team meetings and informal discussions.