Archived: Domiciliary Support Team

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support. The service promoted 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. People with learning disabilities and autism using the service could live as ordinary a life as any citizen.

Everyone we spoke with was happy with the service. One relative told us, “The staff go over and above what is expected. The support is reliable, flexible and the care staff are really supportive to the person they support and the families too. They make a real effort to give my relative a really good quality of life.”

People continued to receive a consistently good service and were protected from avoidable harm. The staff team were well-trained and in sufficient numbers to meet people’s needs.

Staff supported people to engaged in work placements, college courses, volunteer work, fund raising and they regularly took part in sporting and community events.

Healthcare and social care professionals praised the staff team for monitoring people’s healthcare and working together in partnership with them to promote people’s health and general well-being.

The provider and the registered manager used a variety of ways to monitor the quality of the service and to involve people in the running of the service.

Rating at last inspection: At the last inspection the service was rated good (published 19 March 2016).

Why we inspected: This was a planned inspection to check that this service remained good.

Follow up: We will monitor as part of the inspection programme for a good service. If any concerning information is received we may inspect sooner.

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

The domiciliary support team is part of Outreach, Community and Residential Services. The organisation is a registered charity who provide support and personal care to people living in the community and to people living in supported living services. The service provides support to people with a range of needs including people with a learning disability or a mental health condition.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

People told us they felt safe with the support offered. Staff could describe and understood their responsibilities to support people to protect them from abuse and avoidable harm. Staff were recruited safely, which ensured they were of a good character to work with people who used this service.

Overall, people received their medicines as prescribed and safe systems were in place to manage people's medicines. Staff were trained in medication administration and their competency was checked regularly.

People's homes and equipment were regularly checked and the provider had plans to keep people safe during significant incidents, such as a fire.

Sufficient numbers of staff were available to meet people's support needs. People received support from staff who showed kindness and compassion. Their dignity and privacy was protected Staff understood people's individual needs in relation to their care. Support plans were person centred and reflected individual's preferences.

The management team and staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had made appropriate referrals to the relevant authorities to ensure people's rights were protected.

Staff training was updated regularly and staff had regular supervision that helped identify training needs and improve the quality of care.

People who used the service had access to a range of healthcare professionals in order to meet their health needs

People chose their own food and drink and were supported to maintain a balanced diet where this was required.

Care records contained enough information to guide staff on the care and support required and contained information relating to what was important to the person and how any risks were managed. These were reviewed regularly and showed involvement of people who used the service.

The service had a number of ways of involving people and getting their suggestions for how the service could be improved. People who used the service had been involved in planning and reviewing the care provided. They were also involved in recruitment and service quality auditing.

People were supported to pursue social interests relevant to their needs, wishes and interests.

There was an effective complaints procedure for people to raise their concerns. People were confident they would be listened to and action would be taken to resolve any complaints they had. Information on raising concerns was available in accessible formats.

Quality assurance systems that were in place were sufficiently robust to identify areas for improvement. The registered manager and staff were committed and enthusiastic about providing a person centred service for people.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive to people's needs?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them, family members, looking at records and information from Bury Local Authority. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Outreach community and supported living service provides support for up to 26 people with a learning disability or a mental health need. The service is managed from the organisations office Redbank which is located in the Cheatham Hill area of Manchester.

The community and supported living service supports people in the community usually for a few hours a week. The support workers enable people to take part in activities such as shopping or swimming and also may provide people with personal care such as helping with a shower or a bath. They also provide a 24 hour supported living service to people who share a house and are tenants renting a property.

We visited the office and one of the properties which provided accommodation for up to 10 people in four flats. Both the office and the flats were clean, tidy and well maintained both inside and outside of the buildings. We also spoke with two family members of people who lived in two other properties they told us that these properties, were also well maintained.

Training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) took place which ensured that people who were not able to make decisions or choices were protected and kept safe. Best interest meetings and any other legal requirements such as applications to DoLS or guardianships were completed in conjunction with Bury Local Authority.

We saw people had received an assessment of their care needs from Bury Local Authority and Outreach which ensured that the organisation would be able to meet the person's needs.

There were a sufficient number of people employed to ensure that people were supported with their care needs.

Is the service effective?

Training was in place that ensured services were provided by a qualified staff team with up to date skills. National Vocational Qualifications (NVQ) and mandatory training which included moving and handling, safeguarding adults, infection control, mental health awareness, and health and safety were all completed by the staff team.

Each person had three care files; a working file, a health file and an information file. We visited one of the five properties that Outreach provided support to. We looked at the three files for one of the people and found that the files were well organised. The information was comprehensive and showed a good understanding of the person's needs and the support they required.

The property we visited was purpose built by a housing association and had four flats. Two flats accommodated three people and two accommodated two people. All the flats were staffed separately and were personal to the people who lived in them. Everyone had their own room with their own furniture and personal belongings.

Is the service caring?

All of the people we spoke with were happy with the service and the care provided.

We were able to have a conversation with one person who lived at the property we visited and also spoke briefly with four other people who used the service. We also spoke by telephone with four family members. Comments we received included; 'If there was anything wrong I would have no worries about telling staff anything; I go out quite a lot shopping, cinema and disco.' A family member told us; 'I couldn't be happier, fantastic, really pleased with the service." Another person said; 'I feel that my relative is safe and that their privacy and dignity are respected' and another said; 'I now look on the staff as friends and they are marvellous and have a lot of patience."

During our inspection we observed people being treated with respect and patience.

People's preferences were recorded in the care plan and they were able to express their views and opinions through talking to members of the staff team, taking part in reviews and 'house' meetings.

Is the service responsive to people's needs?

We saw that people's needs were assessed before they were offered support by Outreach. We also were told by a family member that their relative had a number of 'sleep overs' to make sure that it would be the right place for them to go and live.

The support to be provided was agreed with the family, Outreach, the local authority and wherever possible the person who was to receive support.

We saw that people's health care needs were met and that they were supported to visit other health care professionals such as GP, opticians and podiatrist.

Is the service well led?

The community and supported living service was part of the wider organisation Outreach Community and Residential Services which is a registered charity.

Surveys were conducted yearly and replies were analysed in order to improve the service provided.

There were 'house' meetings for the tenants and leisure group meetings where items regarding food, activities were discussed.

A representative of Outreach visited the properties every six months and completed a quality monitoring report.

The registered manager, the quality development manager and the staff development manager conducted monitoring visits. After these visits action plans were completed and given to the staff team at the property for them to implement in order to improve the service.

The organisation had the PQASSO (Practical Quality Assurance System for Small Organisations) award which was obtained in 2012. PQASSO is a form of quality management to assist organisations to continuously improve on how they do things and make the organisation adaptable and able to respond to people's changing needs. A review of the award will take place in 2015.