Physical Disabilities Outreach Support Services Bramshurst

Updated 24 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18 December 2017 and was announced. We gave the provider 48 hours' notice because the location provides a domiciliary care service and we wanted to make sure someone was available to talk to us during our inspection.

This inspection was carried out by a single inspector.

During our visit, we spoke with the registered manager, a member of the staff team and a person using the service. Due to frail health of people who used the service we were only able to speak to one person using it.

We looked at records, which included care records for two people, recruitment, supervision and training records for two staff members. We also looked at other documents relating to the management of the service, such as, medicines, care records and training audits.

Following the inspection, we contacted and received feedback from two external health professionals.

Updated 24 February 2018

The inspection took place on 18 December 2017 and was announced. At the last inspection on 27 August 2015 we rated the service Good. At this inspection on the 18 December 2017, we found the service remained Good.

The Physical Disabilities Outreach Support Service Bramhurst, provided a domiciliary care support service from the location and assistance to people with a range of physical disabilities and varying support needs in their own flats at the location. Due to the budget re-evaluation by the provider, the service was scheduled to close down in March 2018. At the time of our inspection, the service was providing care to three people. The service was in the process of finding the most appropriate accommodation for all three individuals that would be in line with their needs and their individual preferences.

Although the provider had made the decision about closing the service the registered manager and the remaining staff team continued to provide good quality of care to people who used the service. There were many good things about the service. It provided care to people with complex needs and behaviour that often challenged the service. We found that there was very positive and trusting relationship between staff and people. People spoke positively about the support they received and staff appeared compassionate and caring towards people.

Staff supported people to take their medicines and the registered manager took appropriate action to address any gaps in medicines management by staff.

People were safe at the service. The risk to people’s health and wellbeing were assessed and managed and accidents and incidents were reported. There were appropriate infection control measures put in place and people were protected from unnecessary infection .Safe recruitment procedures ensured that people were supported by staff that were appropriately vetted. There were sufficient staff deployed to ensure people’s need were met.

People were appropriately assessed and their needs had been discussed before they started receiving support from the service. People were happy with the support they received and they thought staff had the knowledge, skills and experience to support them effectively.

Each person had been receiving the support from the service for at least four years. Staff working at the service were employed there for at least two years. Staff and people told us they knew each other well..

Staff received regular training that the provider considered mandatory. Staff said the registered manager supported them through regular supervision, staff team meetings and working alongside them.

Staff had good knowledge about people dietary needs and preferences and people received appropriate support in relation to their food and drink intake. Staff also supported people to have access to appropriate health professionals and staff worked together and with other health professionals to ensure people received required medical attention.

The service followed the principles of the Mental Capacity Act 2005 (MCA). People’s capacity was assessed by respective professionals if required and there was evidence that people gave their written consent do care and support provided by the service.

People were supported by staff who cared for them, were compassionate and were respectful and responsive to their needs. Staff encouraged people to build on their confidence and life skills.

Staff met with people for regular one to one keywork meetings in which people were encouraged to discuss various elements of their care and decide how they would like their support to be provided. When requested by people staff supported them in following their interests and doing things they liked.

People’s dignity and privacy was respected and when providing personal care staff ensured this was done in a respectful way and how people preferred it.

People received care that was bespoke and in line with people’s needs and preferences. People’s care plans were person centred and gave staff sufficient information on how to support people safely and effectively.

People had access to the provider’s complaints procedure and staff offered their support if people wanted to make a formal complaint about the support they received from the provider or any other service.

There were monitoring systems in place that helped the registered manager to monitor various aspects of the service and to ensure that people received support that was safe and effective and in line with their needs and preferences.

The registered manager and the staff team received positive feedback from external health professionals, who thought staff had positive relationship with people, encouraged them to undertake treatment and accept the support that they had previously refused.

We saw that the service had appropriate policies and procedures in place to guide staff on various areas related to their work and their professional roles.

Further information is in the detailed findings below.