Archived: Raglin Care Ltd

Raglin Care Limited is a supported living agency that provides personal care and support to people living in their own homes. It provides support services to people with a range of needs such as physical disability, learning disabilities and autism. The service is located in Liverpool, and services are provided across Liverpool, Wirral, Sefton, Knowsley and St Helens.

Supported living is where people live either on their own or with a small group of others and have their own tenancy agreement. Care and support is provided in order to promote their independence. The care people receive in supported living settings is regulated by CQC, but the accommodation is not. The service supported some people on a 24-hour basis and others at specific times during the day and night. At the time of the inspection 49 people were being supported by the service with personal care tasks.

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 received 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

There was a strong person-centred culture in the service. Staff empowered people to have a voice and realise their potential. People's individual needs and preferences were reflected in the way care was delivered. We saw multiple examples of how this had improved the lives of people being supported by Raglin Care.

Staff were highly skilled, motivated and knowledgeable. They provided flexible care and support in line with a person's needs and wishes. The staff team was consistent, and people achieved positive outcomes which exceeded expectations. People were able to live in their own homes, reduce social isolation and maintain personal or family relationships.

People were supported by a well trained staff team. Staff undertook comprehensive training tailored to each person being supported. Families were involved in the design and delivery of this training, ensuring people's needs were truly reflected and catered for. This enabled staff to deliver and maintain professional, high quality, person-centred care for people safely and confidently.

The leadership, governance and culture in the service was used to drive and improve the delivery of high-quality person-centred care. The management team had an inspired and shared purpose and fostered a culture of coproduction within the service that ensured people were active participants in their own care, and the delivery of the service. The inclusion of people in decisions about their care and the delivery of the service, had achieved excellent outcomes for people. People felt empowered and truly valued.

People had had the opportunity to choose their own staff and ensure that they were compatible. People told us being involved in the recruitment of staff had improved their well being and helped them in developing positive relationships. Family members told us they had full confidence in the staff and they were more like family to people. People and families told us the staff were kind, compassionate and respectful towards them. They described how they trusted and felt safe with them.

People were supported to engage with activities that interested them and supported with engaging in the community. It was clear staff knew what people liked to do and knew how to support them to avoid social isolation. We saw examples where people had been able to go on holiday for the first time, or spend time alone with loved ones for the first time. This had improved the well being of people supported by Raglin Care and their relatives.

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. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support (PBS) principles. The use of PBS was highly effective in delivering positive outcomes for people. We saw evidence of the use restrictive interventions being greatly reduced.

Care plans focussed on individual goals and outcomes and contained detailed information regarding people’s likes, dislikes and preferences. People told us they developed good relationships with staff and staff knew them well.

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 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.

Risks which compromised people’s health and well-being were appropriately assessed, reviewed when needed and contained detailed information. People told us they felt safe with the service.

Everyone we spoke with was complimentary about the service.

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

Rating at last inspection

The last rating for this service was good (published 9 March 2017).

Why we inspected

This was a planned inspection based on our inspection programme.

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.

The service is located in Liverpool, and services are provided across Liverpool, Wirral, Sefton, Knowsley and St Helens. The service is a supported living service and people are provided with a range of hours per day or per week in line with their assessed needs.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

People were supported to take risks to promote their independence in accordance with their comissioned care. Staff were safely recruited and deployed in sufficient numbers to meet the needs of people using the service. The service recruited staff to the equivalent of 110% of its contracted hours to provide cover for sickness, annual leave and training. Medicines were safely managed within the service by trained staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff received appropriate training and support which allowed them to meet people’s needs effectively. People were supported to maintain a healthy diet and to access healthcare services.

It was clear from our observations and discussions that staff knew people well and tailored the provision of care and support to meet individual needs. Staff involved people in day to day discussions about their care and support and gave them the option to refuse or do something different. People were given information in a way that made sense to them.

The care records that we saw clearly demonstrated that people had been involved in the assessment process and planning of their care. Where people had learning disabilities which limited their understanding of the process, the service had made good use of person-centred planning techniques to maximise their involvement. People’s wishes and aspirations were clearly recorded in files and regularly reviewed. The procedure for receiving and handling complaints was clear. A copy of the complaints procedure was included in the service’s statement of purpose and made available for people using the service or their representatives.

The provider encouraged people and their families to provide feedback through a range of formal and informal mechanisms. The staff that we spoke with were motivated to provide high quality care and understood what was expected of them. The registered manager had sufficient systems and resources available to them to monitor quality and drive improvement. Quality and safety audits were completed on a regular basis.

Further information is in the detailed findings below.

People were well supported with their physical, mental and emotional needs. People's needs were clearly reflected in their care plan and staff presented as having a good understanding of people's needs.

Systems were in place to protect people from the risk of abuse. Staff had undergone training in safeguarding and they were clear in their responsibilities to report concerns.

Checks had been carried out on staff before they started working for the service. These aimed to ensure people were supported by staff who had the appropriate qualities, skills and experience they need to carry out their roles.

Staff felt well supported and appropriately trained. Communication across the staff team was good and staff were being provided with regular supervisions and team meetings.

The provider had a system in place for monitoring the quality of the service and this included asking people who used the service for their views. People who used the service told us they would feel confident to raise any concerns or complaints about the service and we saw that when a complaint had been made it had been listened to and acted upon by the manager.

People using the service and their relatives gave us good feedback about the support people received with their health and personal care.

Each person had a care plan which described their strengths, needs, goals and individual choices and wishes. Care plans had been reviewed on a regular basis to make sure they were up to date.

People gave us good feedback about staff. People told us staff were 'Very good' and one person told us they felt staff were 'Brilliant'. We found that staff had supported the aims and objectives of the service in encouraging people to make choices, use their skills, and participate within their local community.