Archived: Real Life Options - Yorkshire

Updated 14 May 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 03 and 17 February 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service as well as seven supported living locations; we needed to be sure that someone would be in.

On the first day of our inspection one adult social care inspector visited the provider’s premises and looked at how the outreach service which provided community based support was provided. On day two of our inspection, two adult social care inspectors visited three supported living accommodation locations.

At the time of our inspection there were 11 people receiving a service from the community outreach support team. There were an additional 27 people living in supported living accommodation who received a service from the provider. We were only able to speak with two people due to complex communication need. We also spoke with seven relatives of people who received a supported living service and nine members of staff working in the same services. We also spoke with four relatives of people receiving a community outreach service and five members of staff who supported them. We spoke with three service managers, the registered manager and an external professional.

We looked at documents and records that related to people’s care and the management of the service. We looked at three community outreach care plans and another four care plans for people living in supported living.

Before our inspection, we reviewed all the information we held about the home, including previous inspection reports. We contacted the local authority and Healthwatch. Healthwatch feedback stated they had no comments or concerns. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted the local authority who told us they had no reported concerns.

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.

Updated 14 May 2016

This was an announced inspection carried out on 03 and 17 February 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to arrange the visit to their office. This was the first inspection we have carried out for this service.

Real Life Options provides an outreach service to people based in the community. They also provide services to people with learning disabilities in a total of seven supported living locations.

At the time of our inspection the service had 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 and associated Regulations about how the service is run.

In the supported living services we visited, people were well looked after. Due to people’s complex communication needs, we spoke with their relatives to find out about their experience of the service their family member received.

Relatives told us their family members were safe receiving services from the provider. Staff received safeguarding training and were able to recognise and respond to signs of abuse. The provider took appropriate action in response to safeguarding concerns we looked at.

We found shifts were not always covered when regular workers were not available and alternative provision was not always suitable. Recruitment practices were safe as background checks were carried out to ensure staff were suitable to work with vulnerable adults.

Medicines were safely managed by staff who received training and competency checks. Staff received an induction and records we looked at showed they were mostly up-to-date with their training. Supervision and appraisals were carried out but the provider had not provided this support on a regular basis for all staff.

Risk assessments were in place for people living in supported living services and these had been reviewed. However, risk assessments were not always completed for people using the community outreach service.

People were supported to enjoy a balanced diet and they were encouraged to make choices around meals and to participate in cooking. The service worked with a range of health professionals to ensure people received support which met their healthcare needs. However, we found one person’s health check record had not been reviewed since December 2013.

Staff demonstrated how they provided people with choice and encouraged people to make decisions. We saw staff had received training in the Mental Capacity Act (2005), although some staff were unsure how this affected their roles. We saw people in supported living had information on mental capacity in their care plans.

Relatives spoke positively about the staff who worked with their relatives. Staff spoke to people with kindness and patience and found they knew the people they supported well. Staff could describe the action they took to protect people’s privacy and dignity. People were supported to participate in community life through a range of activities.

Relatives knew how to complain and those who had made complaints told us they were satisfied with the response they received.

People had detailed care plans in both community outreach and supported living services which described how staff should provide their care and support. Reviews were taking place which people and staff were involved in, although these were carried out by other professionals, but not used to develop care plans.

Relatives and staff spoke positively about the management team, although additional management support was identified as a need. The provider used a number of different audits to manage continuous improvement of the service, although the schedule of quarterly audits had not been maintained. There were some gaps in engagement with staff and relatives which the registered manager told us they would respond to.

We found breaches in regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.