Archived: Human Support Group Limited - Ulverston

Updated 21 July 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 comprehensive inspection took place on 15 May 2018 and was announced. We called the service 24 hours before to arrange our visit because we wanted to be sure the registered manager would be available to speak with us.

The inspection was carried out by one adult social care inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of caring for someone who has used this type of service. The expert-by-experience had experience of caring for older people who use regulated services.

We visited the office and with the permission of people who used the service and we arranged to visit three of them in their own homes. However we did not manage to speak to all of them. One person attended an emergency doctor’s appointment that had been arranged by the staff.

During our inspection we spoke with 10 people who received personal care from the service and two relatives. We also spoke with 11 care workers, the registered manager and care coordinator. We looked at care records for six people who used the service and at the recruitment and training records for three staff. We also looked at records relating to compliments and complaints and how the provider checked the quality of the service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service, including the information in the PIR, before we visited the service. We also contacted the local authority commissioning and social work teams and local health care providers for their views of the service.

We also used a planning tool to collate all this evidence and information prior to visiting the service.

Updated 21 July 2018

Human Support Group Limited - Ulverston is a care at home service that provides care and support for people who live in their own homes. The office is located in the centre of the town of Ulverston and provides services in and around the local area. Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 42 people were receiving the regulated activity.

At our last inspection in October 2015 we rated the service as good. At this inspection we found some distinctive characteristics of 'outstanding' evident. This was echoed by the consistent and very positive comments in the feedback we received from people who used the service. We saw since our last inspection the service had continued to make positive developments in all of the domains that we rated.

There was 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.

We found the service to be exceptional in helping people to express their views. A diverse approach was used especially in supporting social inclusion and promoting people’s rights. A service user led forum and a regular newsletter had been established by the service. The staff assisted people to attend meetings that were led by people who used the service. One of the initial purposes of the forum was to enable people to have a voice in shaping the services they received. It also enabled access social activities within the community and prevented people from being disadvantaged or feeling socially isolated.

The individualised approach to staff training was particularly effective in ensuring staff had received a variety of training to enable them to support and care for people with varying and specific needs. Staff were also supported through staff meetings, supervision and appraisals. The provider and registered manager regularly gave staff recognition of their hard work using different rewards schemes they had implemented. Staff had been supported into extending their roles as champions in areas of their own interests. This increased staff knowledge and in turn ensured people experienced good outcomes.

People were effectively supported and received care from a regular team of staff who they knew well and people told us were very professional and punctual. Everyone we spoke with made very positive comments about the staff that supported them. People told us this was an excellent and outstanding service and said they would definitely recommend it.

The systems in place to organise the delivery of care were very efficient and managed by a designated coordinator. The frequency and duration of visits provided ranged depending on people's individual needs. There were sufficient numbers of suitably qualified staff available to meet people’s needs and to allow flexibility in the service should people make a request to alter their visit times. People could decide who provided their care and support and when.

When employing fit and proper persons the recruitment procedures had included all of the necessary checks of suitability. The people who used the service had been involved in developing the recruitment process used by the provider.

There was a comprehensive safety management system in place for carrying out risk assessments to ensure hazards to people's safety had been identified and were appropriately managed. The service had contributed to the development of best practise and good leadership with other agencies to assess and minimise risks.

All the people we spoke to said they felt safe in their home environment with the care workers that attended. Staff understood their responsibilities in the safeguarding of vulnerable people. Where safeguarding concerns or incidents had occurred these had been reported by the registered manager to the appropriate authorities. We saw actions had been implemented by the service from any lessons learned to protect people further.

People told us their dignity and privacy were actively promoted by the staff supporting them. The service had implemented a development plan and additional staff training. This was to ensure they incorporated meeting the needs of older lesbian, gay, bisexual and transgender people (LGBT). This was done not just for those who might use their service but also to raise awareness within the local community.

The service user forum had developed in many ways including enabling people who had lost confidence to go outdoors become more confident and achieve their personal goals with the support of the agency staff. The forum also gave people who used the service a voice in how the service should be delivered or improved. We saw that the provider had been exceptionally responsive in delivering what people had requested.

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. We saw that staff had created really positive, caring and empowering relationships with those people they supported. One person said, “Care workers are genuinely caring and compassionate. Very personalised and very professional.”

The provider produced regular bulletins, information and guidance for people who used the service. Information and guidance was also collated and shared locally in a newsletter produced by the agency. The information provided covered a wide range of topics such as, how to keep safe in certain events, tips on keeping healthy and promoting the local Alzheimer’s Society Dementia Friends meetings set up locally by the registered manager as the service’s dementia champion.

There was a positive culture and the values demonstrated by the service placed people at the heart of the service. There was a whole team culture, the focus of which was how they could do things better for people who used the agency. The registered manager and staff team had taken the lead in a companywide initiative called ‘project outstanding’. This was instigated to promote the company’s mission, vision, values and behaviours in demonstrating how the service provided could be outstanding.

People received the right level of support they needed to take their medicines safely. People were supported to eat meals of their choice and staff understood the importance of people having a nutritional diet. Auditing and quality monitoring systems were in place that allowed the service to demonstrate effectively the safety and quality of the provision.

The staff identified if people were unwell and supported them to contact local health professionals where necessary. The agency had a designated nurse manager who was part of the company’s healthcare team. This meant staff could access professional advice and guidance in supporting people with their health care needs. The service worked collaboratively with a variety of other agencies to enhance the care and support for people.

People were asked for their consent before care was provided and the decisions they made were respected. People told us they had been fully involved in the development and reviews of their care.

The registered manager demonstrated a good understanding of the importance of having effective quality assurance systems. She had strong values and a real desire to implement and share best practice throughout the service.

Further information is in the detailed findings below