Archived: IAS 65 Chorley Road

Updated 4 June 2015

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 inspection took place on 05 May 2015 and was announced. We provided 48 hours’ notice of the inspection to ensure management were available at their Trafford and Salford office to facilitate our inspection. The inspection was carried out by one adult social care inspector from the Care Quality Commission and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed information we held about the service in the form of statutory notifications received from the service and any safeguarding or whistleblowing incidents which may have occurred. We also liaised with external providers including Trafford Council.

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.

Imagine Act and Succeed (IAS) is a registered charity that supports people in Greater Manchester to live an ordinary life; in the community, at home or with family. At the time of our inspection there were 86 people living in the Trafford and Salford area who used the service, of whom 18 received personal care. Other services consisted of supporting people to access the community, shopping and budgeting. The service employed 67 members of staff. During the inspection, we spent time at the office and looked at various documentation including care plans and staff personnel files.

We also spent time visiting five people who used the service in their own homes to ask them about the service they received. We also spoke to eight relatives and friends of people who used the service. We spoke with eleven members of staff, which included the Head of Operations, the Registered Manager and a Deputy Manager. We also spoke to three social care professionals and one health care professional as part of our visit.

Updated 4 June 2015

This was an announced inspection carried out on the 05 May 2015.

Imagine, Act and Succeed (IAS), is a local registered charity that provides support services for adults whose primary need for care is due to their learning disability throughout the North West. Support is provided for people, with varying complexity of needs, who choose to live alone or who share a home with others. IAS 65 Chorley Road provides support to people living in the Salford and Trafford areas.

There was a registered manager in place. 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.

At the last inspection carried out in October 2013, we did not identify any concerns with the care and support provided to people by the service.

People who used the service told us they felt safe and trusted staff who provided support. Without exception, people who used the service and their relatives were complimentary and positive about the staff who supported them. One person who used the service told us; “I like them very much, they are very kind.” Another person who used the service said “I feel safe and trust them coming into my apartment.”

We found suitable safeguarding procedures in place, which were designed to protect vulnerable people from abuse and the risk of abuse. One relative told us; “As a family we are very happy with the service we get. I have no worries that X would be abused, mistreated in any way and that is a big thing for us to know he is safe.” Staff told us the service encouraged an open and transparent culture and that they would have no hesitation in reporting any concerns. One social care professional we spoke with told us that the service was very responsive to safeguarding concerns and very progressive in their approach. They added that people who used such services would be a lot safer if other providers responded and acted in the same manner as IAS.

We found people were protected against the risks of abuse, because the service had robust recruitment procedures in place. We found appropriate criminal records bureau (CRB) disclosures or Disclosure and Barring Service (DBS) checks had been undertaken and suitable references obtained before new staff commenced employment with the service.

The registered manager told us the service had developed a person centred approach to risk that included ‘just enough support’ at its centre. This work undertaken in in conjunction with the people who used the service, their families and other stakeholders, was based on listening to what was important to people.

We found all staff administering medication had received training and had annual assessments of their competency to administer medication. We found the service used a pain recognition tool to support people who had difficulty communicating pain and distress they may have been experiencing. This included a pictorial pain indication chart, which people could use to help staff determine the level of pain or discomfort they were experiencing.

We found all new members of staff underwent a comprehensive induction programme, which was designed to welcome them to the service and support them during their probationary period of 12 months. We reviewed training records, which were up to date with required refresher training courses in order to allow staff to develop their skills and knowledge. Staff were also able to access individual specific training to help them effectively support people with particular needs such as autism. We found the service provided ‘person centred / positive risk taking’ training for all team leaders.

Both manager and staff confirmed they received regular supervision and appraisals, which we verified by looking at staff personnel records. Comments from staff included; “I feel very supported, I have regular supervision and training and we can always ask for training relevant to our roles.” “I meet with my manager regularly and feel fully supported and accommodated with my own personal further educational needs.”

We looked at service policy guidance on the Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS) and obtaining consent from people. We saw that the service had been involved with other professionals undertaking mental capacity assessments. Care staff we spoke with demonstrated a good understanding of the requirements of MCA and DoLS and confirmed they received annual training, known as cascade, which included DoLS as part of their safeguarding training.

The service used a range of pictorial leaflets and forms for people who had difficulty communicating to help them explain what support and care they needed. These enabled people to explain what support they required in their day-to-day life and included helping them to decide their future and supporting their involvement in the community and with relationships.

We saw that the home worked closely with other professionals and agencies in order to meet people’s support requirements. One social care professional told us that the staff had been keen to learn about one of their clients and had not been fazed by their challenging behaviours. As a staff team they had discussed the client’s needs in order to establish what was best for them and always liaised with professional if they have any concerns.

We asked people and their relatives how they felt about the caring approach of the service. Without exception, people and relatives praised the staff for their caring and professional approach. One person who used the service told us; “I’m happy with them, I can trust them yes and they are good at helping me.”

People and relatives told us they were involved in making decisions about their care and were listened to by the service. They told us they had been involved in determining the care they needed and had been consulted and involved in reviews of care.

We looked at how the service promoted people’s privacy and dignity. Each person we spoke with confirmed staff always treated them or their loved ones with dignity and respect. We found that dignity in care was a standard agenda item in team meetings and job consultations / supervision and the service supported staff to reflect on how they promoted this in daily work. The service had two representatives who attended the Trafford Dignity in Care Forum.

Staff consistently told us that as a service, they always considered how they could do more to support people including encouraging more independence. One member of staff explained to us how as a service, they had encouraged one person who used the service to join a day scheme involving outdoor experiences.

People told us that the service had made a real difference to people’s lives. Three people we spoke with told us their relatives were living better lives than previously, they were doing more and becoming more independent. Two people told us their relative had previously lived at home and led quite protected lives, not going out much. They had nothing but praise for the service in enhancing their relatives’ lives. One person said “They’ve transformed his life.”

We looked at a sample of eight care files to understand how the service delivered personalised care that was responsive to people’s needs. Before people started using the service, a comprehensive and detailed assessment was undertaken involving the person who used the service, their relatives and other health and social professionals.

People told us the service engaged consistently and meaningfully with families. One relative told us; “We have found the service to be very responsive and will always contact me to ensure I’m happy with any decisions they make. They are not shy about making decisions, but will always contact to us.”

We asked people how the service supported them in social activities. One person who used the service told us; “We go out to ten pin bowling, coffee and they take me to the gym.” One relative told us that the service took their relative to church, which was very important to them.

Both people we spoke with and staff consistently told us that the service was well run and provided positive leadership. One social care professional told us that the service was well-led with a clear understanding of their values and demonstrated that people who used the service were at the heart of what they did.

We found the service promoted an open culture, was person centred, inclusive, open and transparent. As part of the recruitment policy, people who used the service and families were able to participate in the interview process to determine the suitability of new staff.

The service also used a ‘matching staff’ tool during the recruitment process. This tool asked people what they wanted from their support staff and what they didn’t want and included hobbies, interests, skills and characteristics. The service ethos was that although the expectation is that staff will support people with whatever choice they make, it is a much more enjoyable and effective experience if the member of staff has a passion or interest in the same things as the person they supported.

We looked at the service training and development strategy. The service provided a comprehensive induction programme for staff and ensured that subsequent staff development was a high priority for the service. Staff told us they were proud to be part of the organisation, they were supported and felt valued. Staff were clear about their roles in supporting people to be independent with access to the local community and always looking at how they could improve peoples’ lives.

The service was part of the ‘ethical charter’, having worked closely with union representatives to ensure the service valued their staff and promoted staff wellbeing in respect of wages and working conditions. The service had also recently started an ‘employee assistance programme’, which was a service that allowed staff to talk confidentially to a counsellor who could offer support and refer to other professionals if required. In addition to wellbeing support the scheme also offered financial, medical and legal advice.

The service undertook a comprehensive range of audits to monitor the quality service delivery. These included medication audits, health and safety checks, water temperature checks and team leader’s quality checks which focused on records and documents. Where issues had been identified, action plans had been devised to support improvements. We looked at staff observations assessments for medication administration.

We looked at minutes from the tenant’s forum, which included pictorial diagrams to help people understand and covered areas such as hobbies, what people would like to do and travelling. We also looked at minutes from the service development meetings and included areas such as training strategy, medication and team working.

We looked at minutes from the compliments and complaints review meetings, which analysed the issues raised and where relevant provided feedback to staff.

We found the service had been accredited with Investors in People recognition. Investors in People is a management framework for high performance through people.

The service had been awarded a “Dignity in Care” award by Trafford Local Authority in December 2014. To achieve this award the service had to produce evidence against a number of standards in relation to how they promote and measured dignity throughout the service.