Pendle Support Limited

Pendle Support Limited is registered to provide both supported living services and domiciliary care services to people who require personal care. The service provides support to younger adults and older people with a physical disability, sensory impairment, learning disability or autistic spectrum disorder. At the time of our inspection there were 126 people using this service, including 38 people who were receiving personal care. The service supported people in their own homes and across 3 supported living sites.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support

Lessons learnt took place following on from an incident. However, the records were not always updated to reflect this. The registered manager was looking into implementing a more robust system. 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. Views on staffing levels were mixed and the provider was in the process of recruiting more staff. Recruitment processes were managed safely, and we were assured IPC practices were safe. Staff supported people to eat and drink in line with their preferences and to enjoy meaningful activities. Staff treated people with dignity and respect.

Right Care

Medicines were not always being managed safely. People’s needs were assessed prior to them starting to use the service and care plans included people’s goals and ambitions for the future. People were treated well, and their individuality was respected. Training completion rates were high. No one at this service was receiving end of life care. However, staff had not had training in this area. This was rectified during the inspection process.

Right Culture

Governance systems were not always effective at improving the quality and safety of the service. Audits were either not in place or did not identify concerns found during the inspection process. Staff did not always attend regular meetings and supervision and felt there was a lack of communication between themselves and the office. We made a recommendation about this. There was a complaints procedure in place and people felt comfortable raising concerns. The registered manager was described as approachable. Staff were aware of their safeguarding responsibilities and felt comfortable raising concerns. People’s communication needs were considered.

For more details, please see the full report for Pendle Support Limited which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 8 December 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to medicines and good governance. We made recommendations in relation staff engagement with the service and management team.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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 2008 and associated Regulations about how the service is run.

Pendle Support Limited is registered to provide personal care and support to adults and children with learning disabilities and associated mental health issues. The agency is located in the town of Colne and provides a community service within the Burnley, Pendle and Rossendale area.

This was the first inspection for Pendle Support Limited as the service had become a limited company and re-registered with the Care Quality Commission on 23 July 2016. Prior to this the service was registered as Pendle Care and Support Services as a partnership and had been providing services in Burnley, Pendle and Rossendale since 2005. Our last report for the previously registered service was in February 2014 and the service was judged to be fully compliant under the previous regulations. At the time of our inspection 28 people were being supported by the agency.

Without exception people told us that they felt safe when receiving care and support from staff. Staff we spoke with knew how to recognise and report potential safeguarding issues and they received appropriate training in this area which was up to date.

There was a robust and detailed recruitment programme in place that helped to ensure people received high standards of care from a highly skilled staff team. People who used the service were given the opportunity to become involved within the recruitment process. Staffing levels were sufficient to ensure people received high standards of care that enhanced their welfare, safety and day to day living.

Thorough risk assessments were in place to protect people from risks but also enabled them to take positive risks. We saw that people and families were involved within this process to enable them to understand why they were in place. Risk assessments were person centred and up to date.

People we spoke with had no concerns with how staff helped them to take their medication. An up to date medication policy was in place that staff were aware of. Staff knew their responsibilities in this area and were trained to administer people’s medicines.

Staff received an induction when they first started work at the service. Staff were trained, supervised and received an annual appraisal of their performance. Staff told us they felt supported in their role and were given the appropriate training and guidance to carry out their duties effectively.

Staff and the management demonstrated a good understanding of the principles of the MCA and DoLS and how it related to peoples care needs. Up to date and detailed policies and procedures for MCA and DoLS were available to all of the staff and provided them with clear guidance.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Support and care plans reflected people’s assessed support needs well and showed that people were encouraged to do as much for themselves as possible. Care plans also reflected the fact that people were involved in the care planning and review process. Care plans were very person centred, up to date and contained in-depth information and guidance for staff. Staff we spoke with found plans to be useful in assisting them to provided care and support for people.

People we spoke with told us they were happy with the care and support they received and that staff were caring and considerate. Nobody we spoke with raised any issues about how staff conducted themselves when providing care in their home and were very complimentary about their attitude, conduct and professionalism.

People told us their privacy and dignity were respected and promoted by the care staff.

We saw many good examples of how people were supported to remain living independently and the people and relatives we spoke with confirmed this. People with complex care and health needs were supported to live at home due to the professionalism of the service and its carers both in terms of the care and support delivered and the liaison with other professionals to make this possible.

A large amount of information and guidance was made available to people in a number of different formats. This helped people to be informed about the service and local issues as well as making them aware of local activities and events.

People knew how to raise issues or make a complaint and told us they were confident if they did that an effective response would be gained. Staff spoken with knew the agency’s complaints policy and how to assist people to raise concerns if needed.

People and relatives we spoke with talked extremely positively about the management of the service, the staff and the care and support they or their loved ones received.

We saw evidence of an extremely effective auditing and monitoring system. We also saw that people were regularly asked their opinion of the service via a number of methods including annual quality surveys, phone calls and care reviews.

The service had exceptionally good links into the local community and had created a number of successful community engagement programmes when local provision was seen to be lacking. The registered manager, who was also one of the two owners, owners and management team were passionate about the care they delivered and this was evident in the feedback we received form people using the service, families and professionals.