The inspection took place on 5 January 2016 and was unannounced. Our last inspection of this service took place in December 2013 when no breaches of legal requirements were identified.Community Solutions is registered to provide accommodation for up to 13 people who require personal care. People live in shared houses and, flats, and individual houses. All bedrooms have en-suite bathrooms. The service specialises in supporting younger adults with a learning disability and autistic spectrum disorder. The service is based in the centre of Thorne, within walking distance of local facilities including, shops, cafes, restaurants, parks and leisure facilities.
The service had a registered manager in post at the time of our inspection. 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.
Some people we spoke with had limited verbal communication. However, everyone very clearly indicated they felt safe and were happy living in the service, liked the staff and did the activities they liked to do.
Staff we spoke with had a clear understanding of safeguarding people and they were confident their managers and the rest of their team would act appropriately to safeguard people from abuse.
The support plans we looked at included risk assessments, which identified any risks associated with people’s care, and had been devised to help minimise and monitor the risks without placing undue restrictions on people. People’s medicines were well managed.
Everywhere was very clean and well maintained, and there were effective health and safety audits in place.
There were enough staff to keep people safe and to meet people’s individual needs, and the staff told us they received good training and support. Thorough recruitment checks were undertaken before staff started work in the service.
The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. MCA assessments and ‘best interests’ decisions had been made where there were doubts about a person’s capacity to make a specific decision. DoLS applications had been made appropriately to the local authority.
There was good guidance for staff regarding how people expressed pain or discomfort, so they could respond appropriately and seek input from health care professionals, if necessary. People had access to a good range of health care services and staff actively advocated for people if they felt health care services were not as responsive as they should be.
People were supported to have a good, well balanced diet and people’s individual needs and choices were catered for. They also had good access to a range of health care services, and received good health care support.
Staff retention was good, and staff knew people well and had built good relationships. There was also a good mix of staff.
Staff spoke to people in a caring and positive way, treated people with respect and were mindful of their rights and dignity. There was a nice, relaxed atmosphere and people were relaxed and smiling in the presence of the support staff.
There were very good care and support plans and information for staff about people’s likes and dislikes and we saw that staff were very good at monitoring people’s reactions and responses and responding to people in positive way. People were involved in choices about all aspects of their lives.
We found that staff respected people’s spiritual and cultural needs. Staff were knowledgeable about this aspect of people’s needs and this information was also clearly reflected in people’s care and support plans. The care plans themselves were detailed and thoughtful, and included pictures and photographs to enhance people’s understanding and involvement.
People had full lives, engaging in lots of activities, and this included in the evenings and at weekends. They were encouraged to keep in touch with the people who were important to them, such as their family members. People and their close family members, were encouraged to make their views known about their care. An independent advocate had sometimes helped people with this. An advocate is someone who speaks up on people’s behalf.
The complaints process was clear and people’s comments and complaints were taken very seriously, investigated and responded to in a timely way. People didn’t have any complaints to tell us about and indicated they were happy.
The registered manager was very person centred in their approach. Person centred care is when staff understand what is important to the person and give them the right care and support to do the things they want.
There was a good range of quality and safety audits, undertaken by staff and managers.
People had a chance to say what they thought about the service and the service learned from its mistakes, using comments, complaints and incidents as an opportunity for learning and improvement.