St Anne's Community Services - North Tyneside DCA

St Anne's Community Services - North Tyneside DCA is a ‘supported living’ service providing personal care to people, some of whom have a learning disability and/or autism living in their own homes. The service was supporting 8 people with personal care at the time of our inspection.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support

¿ People were relaxed in their own homes, where they could be themselves. They enjoyed the rapport they had built up with staff. Staff helped people enjoy a good quality of life and encouraged them to pursue a range of interests.

¿ Staff worked well with people, their relatives and external professionals, such as social workers, to ensure they had the right support to meet their changing needs.

¿ People experienced good health and wellbeing outcomes. Staff worked in line with the principles of Stopping the Over-Medication of People living with Autism and/or a Learning Disability (STOMP) to ensure the use of medicines was reviewed and reduced where possible.

Right Care

¿ Staff took the time to get to know people. They knew the best ways to encourage people to be independent and how to proactively support them. Staff celebrated people’s achievements and independence.

¿ Staff understood people’ needs in detail. There were person-centred plans in place to help new staff and external professionals gain a comprehensive understanding of people. The provider was actively reviewing and improving these plans regularly.

¿ Staff worked proactively and promptly with external professionals to keep people safe. They sought and followed advice when it was needed. They tried new approaches and if they didn’t work, tried another approach.

Right culture

¿ The culture of the service was focussed on keeping people safe and ensuring they could lead fulfilled lives. The oversight of good practice had not always been effective – the provider had identified this and taken steps to make improvements prior to our inspection visit. Some audits and quality checks/visits had not always happened as planned but staff had consistently provided high levels of care to people. Staff had worked hard as a team to ensure any shortfalls in auditing and oversight had not had an impact on people’s care or the outcomes they achieved.

¿ People and their relatives were involved in decisions about their care and how the service was run.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

St Anne's Community Services - North Tyneside DCA is a domiciliary care agency. It provides personal care to adults living in their own houses in the community. On the day of our inspection there were nine people using the service.

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.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 last inspected the service in February 2016 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

The service provided exceptionally person-centred care. Person-centred means the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

People were involved in the running of the service. The registered manager told us, “Clients are at the centre of everything we do and they lead the services that we provide.”

The service was exceptional at supporting people to maintain their independence and staff treated people with dignity and respect.

People had ‘Accessible information’ support plans in place. The accessible information standard was introduced in 2016 to ensure anyone with a disability, impairment or sensory loss is given information they can easily read or understand. The plans described how people communicated, what their preferences were and how staff could support them with their communication needs.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding, procedures had been followed and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care records showed that people’s needs were assessed before they started using the service. People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

Activities and holidays were arranged for people who used the service based on their likes and interests and to help meet their social needs.

People who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys.

Further information is in the detailed findings below.

This inspection took place on 9 and 11 February 2016 and was announced. We last inspected this service in January 2014, at which time we found them to be compliant against all the regulations that we inspected.

The service had a registered manager in post. 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 living at home with support from the staff. Staff understood their responsibilities to report any safeguarding concerns to the registered manager. People and staff told us they felt there were enough staff employed at the service to provide a consistent service and we confirmed this through records.

Policies and procedures were in place to support the smooth running of the service. Personal emergency evacuation plans were in place and regular checks on the safety of people’s homes were carried out.

Medicines were managed safely and in line with safe working practices and records were well maintained and accurate.

Accidents and incidents were recorded and monitored and where appropriate, care records showed that risks associated with individual care needs had been assessed and were monitored. There was evidence to demonstrate that regular reviews were carried out and the information was passed onto the support workers and other health and social care professionals where appropriate. Annual surveys were used to gather feedback from people about the service they received.

Evidence showed the registered manager and staff had an understanding of the Mental Capacity Act (MCA) and their own responsibilities. The service had assessed people’s mental capacity and reviewed it. Care records showed that wherever possible people had been involved in making some decisions, but significant decisions regarding people’s care were made in people’s best interests and had been appropriately taken with other professionals and relatives involved.

People told us they were supported by staff to maintain a well-balanced healthy diet. We found staff were trained and received induction, supervision and annual appraisal from the management team.

People were respected and their dignity was maintained. Staff displayed kind and caring attitudes and treated people as individuals. People’s care needs were detailed, recorded and reviewed by staff with input from people, their families and healthcare professionals. The registered manager told us they were in the process of updating people’s care records with the new wellbeing and outcome based documentation which had been recently introduced.

Staff offered people a choice in all aspects of daily life and people participated in a wide range of activities. Staff promoted social inclusion and supported people to maintain links with family and friends. People and their relatives told us they knew how to complain and would feel confident to do so if necessary.

Staff told us they worked well as a team. They felt supported by the registered manager and deputies who staff said were approachable and made them feel valued.

The registered manager held a comprehensive set of records which showed the monitoring of quality and safety of the service. Audits took place to ensure staff were undertaking their job competently.

how this care and support was carried out.

We found members of staff were very attentive to people's needs. People looked well cared for and at ease with the staff members who were supporting them. People's needs were assessed and care and support was planned and delivered in line with their individual support plan.

Person centred care plans were in place, which included pictorial information to help with people's communication needs. These were regularly updated and contained clear information about individuals' care. People or their relatives had been involved.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard.

People's personal records were accurate, fit for purpose and held securely. Staff records were kept in an appropriate form.

We viewed care records for three people. We found that care needs were assessed, planned and delivered in a way which met people's individual needs. We found that people had knowledge of, and had consented to, their care plans. People told us, "They (staff) help me and I enjoy all the things that we do" and "I am happy with the care and support I get."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that staff were trained and supported in their roles. People told us, "All of them (staff) are just lovely."

People confirmed they were given the opportunity to comment on the service, change their care routine or raise complaints.

We found that the provider had an effective system to regularly assess and monitor the quality of service that people received.