16 July 2019
During a routine inspection
Freedom Care and Support is registered to provide personal care to people in their own homes. The service specialises in providing support to people with a learning disability, autism and physical disability. Support is provided to both individuals in the family home and to people living in supported living tenancies. At the time of our inspection there were 25 people using the service within East Lancashire and Cheshire.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
People’s experience of using this service and what we found
People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. The service ensured any incidents were recorded and investigated. Staff had been recruited safely and people were involved in recruiting their staff. Medicines were managed safely.
People's needs had been thoroughly assessed and care plans were detailed. staff knew the people extremely well and felt the care plans provided enough information to understand what support the person needed. Staff had received regular training and supervision to support them to meet people's needs. A comprehensive induction programme ensured new staff had a good understanding of their role and the values of the organisation. People were supported to maintain their health and wellbeing, through access to a range of health services.
The service was compliant with the Mental Capacity Act. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The service promoted people's choices.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting 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 received person-centred care which was responsive to their needs. Care and support plans had been regularly reviewed to reflect any changes in the person’s needs and wishes. People had been referred for further input from professionals when required. People were encouraged to raise any concerns. No formal complaints had been received.
The registered manager was committed to providing high-quality, person-centred care. Staff spoke highly of the registered manager and the values they set. Roles and responsibilities were clear. Regular audits ensured care was provided effectively and records were accurately maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 6 July 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.