We carried out a review of the data available to us about One to One Plus North 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 One to One Plus North, you can give feedback on this service.
One to One plus North is a domiciliary service provided by Outreach 3 Way, which is part of Dimensions. One to One plus North provide personal care to 20 people of varying ages in their own homes or supported living services. Not everyone who used the service received 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
People’s experience of using this service and what we found
People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not always support this practice.
Peoples topical prescriptions, such as creams and lotions were not always stored in-line with best practice guidance. Oral medicines were administered, stored and recorded safely. People were supported by staff who had been recruited and trained safely. Staff were knowledgeable about safeguarding and were aware of systems in place to keep people safe from abuse. Accidents and Incidents were recorded and used to improve the safety of the service.
End of life care planning was not always in place for people. Peoples day to day care was personalised to them, care was flexible and driven by people's needs and wishes. People were supported to be a part of their local community and pursue activities that they enjoyed.
Management oversight was not always robust and had not identified concerns identified in this inspection. The registered manager encouraged a culture of continuous learning and improvement and encouraged regular feedback from people and families in order to drive the improvement of the service.
We have made recommendations regarding, how the mental capacity act is implemented and quality assurance of the service.
People were treated with kindness and respect. Staff understood and responded to people's different communication styles and people were supported to make choices regarding their care
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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. (Published 27 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
One to One Plus North forms part of a larger service provided by Outreach 3 Way which is part of Dimensions. This includes outreach services, supported living and day centres, all of which fall outside of the Care Quality Commission’s scope of registration. The domiciliary care provides personal care to people living in their own homes or within the supported living services. At the time of our inspection, the service supported 20 people with personal care. The service works with people with a learning disability and autism. Due to their complex needs, people were not able to tell us in any detail about their experiences of the care they received.
The service had a manager in place that was not registered with Care Quality Commission, however an application had been submitted. 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 were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence.
People were safe with the staff and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.
People were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way.
Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.
There were enough staff deployed to support people with their assessed needs. The manager considered people’s needs when allocating staff and staffing levels were calculated appropriately. The manager followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.
People benefited from receiving a service from staff who worked well together as a team. Staff were confident they could take any concerns to the management and these would be taken seriously. People were aware of how to raise a concern and were confident appropriate action would be taken.
People and their relatives were empowered to contribute to improve the service. They had opportunities to feedback their views about the service and quality of the care they had received.
People the expert spoke with confirmed they were very happy with the care and support that had been provided. The expert by experience provided us with a written report of their findings. They reported, 'They (the provider) promote new and interesting hobbies for the service users. They are also encouraged to explore different things and broaden their minds. Also they (service users) have a group session called 'Everybody Counts' and this is where they discuss any changes they want and any improvements to make the service better.'
We also rang five care workers after we had visited the office. We were able to speak to one care worker. The others were not available when we rang the numbers given to us by the manager. We informed the manager of that we were unable to make contact with some care workers. This care worker demonstrated that they had a good understanding of their roles and responsibilities. They were also knowledgeable about the individual needs of each person they visited to provide personal care.
We also gathered evidence of people's experiences of the service by looking at a selection of records. They included care records and care workers' recruitment records. We found that the records we looked at were up to date and well maintained. They also ensured people received care that was safe, appropriate and in accordance with individual wishes and needs.
We asked about the agency's systems for monitoring the quality of the service provided. We were provided with evidence that people had been asked for their views about the service. We were also provided with evidence that demonstrated representatives of the provider conducted compliance audits of the service every three months.
People expressed satisfaction with the agency and with the quality of care provided. People said that care workers treated them with respect and that they felt safe with the care and support they received. One person told us, "I am happy with the care I receive." A relative told us, 'They are really good. They treat my relative really well, as if they are one of their own!' A second relative told us, 'I think the manager is very accessible and the agency is well run. The support they provide is excellent; my relative gets a good service. The staff are well trained.'
They also confirmed they had been given a copy of their care plan and that they had agreed to the care provided. Care workers we spoke with confirmed they had received training to ensure they had the skills and knowledge to perform the tasks expected of them.
We looked at a selection of care records. They demonstrated that the planning and delivery of care had been routinely reviewed to ensure they met people's current needs.