30 October 2019
During a routine inspection
FHS24 Nursing+Care Agency is a care at home service that provides personal care including supported living and live in care for people with learning difficulties, mental health, autism and older people. At the time of the inspection four people were receiving support with personal care. People had limited verbal communication, so we captured some of their experience through observations.
CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The service for people with learning disabilities and/or autism 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.
People’s experience of using this service and what we found
Improvements had been made with recruitment practices, the provider was now notifying the Care Quality Commission in line with legislation and the provider’s auditing systems had identified concerns. However, it is not clear whether these improvements were sustainable yet. Additionally, small concerns found on the inspection had not always been identified by the management. Although they were proactive at responding to them.
People told us they were happy and appeared comfortable in the presence of staff. Medicines were administered safely. Most risks had been identified with ways to mitigate them in place. However, concerns were found with one person who had a specialist eating and drinking plan. Following the inspection, the registered manager had taken action to rectify them. Records and processes around the management of behaviours which could challenge themselves or others were in place.
The management strove to be open and constantly develop and improve the support people were received. When systems had identified issues, actions were being taken.
People were supported by enough staff to meet their needs. Staff had received a range of training including specialist courses in health and social care. Care plans were personalised and provided a range of information for staff to use to support people’s needs and wishes. There were good links with other health and social care professionals.
Staff were kind and caring and knew the people they were supporting well. Staff respected privacy and dignity. Links had been developed with the community which had a positive impact for people. Independence was promoted, as were the values of treating each person as an individual.
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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service who had learning disabilities and/or autism 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 with learning disabilities and/or autism 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.
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 4 January 2019) and there were multiple breaches in regulation. The provider completed an action plan and met with us to tell us how they would improve. We also completed an inspection to follow up the warning notice (published 13 June 2019) where the rating was not change. At this inspection we found improvements had been made and the provider was no longer in breach of any regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
Since the last inspection we recognised that the provider had failed to display their ratings on their website. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.
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.