The inspection took place on 28 August 2018, The inspection was announced which means that we gave the provider 48 hours’ notice of the inspection to ensure key staff were available to speak with us. Amity Supported Living is a domiciliary care agency. It provides personal care to people living in their own homes. The service supports people with learning disabilities, autistic spectrum disorder and mental health needs. Some of the people using the service lived in shared accommodation where staff from Amity Supported Living provided 24-hour support. Others lived alone or with family members. Not everyone using the service received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', that is, help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, the service was providing a ‘personal care’ service to two people.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support an overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. 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. 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.
The registered manager was supported by a number of front line coordinators who had delegated day to day responsibility for managing the delivery of care within people’s homes. The registered manager was also one of the two registered providers. Both the registered manager and provider retained a high level of involvement in the day to day support and management of the service.
Staff who administered medicines had completed training and underwent competency assessments. Staff used medicine administration records (MARs) to document the administration of people’s medicines. These contained sufficient information to ensure the safe administration of medicines.
Staff had received training in safeguarding adults and the organisation had appropriate policies and procedures in place. This ensured staff had clear guidance about what they must do if they suspected abuse was taking place.
Individual risk assessments were in place which helped to ensure people were kept safe from harm.
Staffing levels were adequate and staff were well supported by an effective on call service.
People were protected from cross infection. Staff had completed infection control training and wore protective gloves and aprons when providing personal care.
People and their relatives felt the service provided effective care and support which made a real difference to people’s lives.
Staff had received training on the Mental Capacity Act 2005 and understood their responsibilities in relation to this and to respecting people’s choices and decisions. Action is being taken to ensure that records always include a mental capacity assessment to support best interests’ decision making.
New staff completed an induction and were required to complete a range of training which prepared them for their role.
People were supported to improve their health through good nutrition and to eat a well-balanced diet and make healthy eating choices.
Where necessary a range of healthcare professionals including GPs, and other community healthcare professionals, had been involved in planning peoples support to ensure their health care needs were met.
Amity Supported Living did not own the premises where people lived, but did carry out annual checks of the premises to help ensure these remained safe and pleasant environments for people to live in and staff to work in.
People were cared for staff who were kind and caring. Staff spoke fondly and with passion about their role and the people they supported. Staff understood the importance of encouraging people to maintain their independence.
People’s care and support plans were personalised and their life histories, preferences and choices were detailed throughout their care records.
People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.
Complaints policies and procedures were in place and were available in easy read formats. These gave clear information about how and with whom people could raise concerns or complaints.
People had a good relationship with the registered manager and provider and valued their support and presence in their lives.
There were some systems in place to check the quality and safety of the care being provided, but plans were in place to develop the governance arrangements within the service further and use this to drive improvements.
The registered manager and provider had a clear vision for how they wanted the service to develop, but also a good understanding of the challenges facing the service and the areas where improvement or developments were needed. They had fostered a positive culture within the service and staff clearly enjoyed their work and felt well supported.