This announced inspection was carried out on 11 and 12 December 2018 by an adult social care inspector. We gave the registered manager 24-hours’ notice of our inspection. This is because we needed to make sure that someone would be available to assist us with our inspection.Wirral & Liverpool Community Services is a domiciliary care service run by The Disabilities Trust. The service is registered to provide personal care to adults within their own homes. The service offers support to older people and people with learning disabilities, sensory impairments and physical disabilities, including acquired brain injuries.
The service’s office is based at Redford Court, a care home specialising in the rehabilitation, support and care for people who have an acquired a brain injury. Redford Court is run by the Brain Injury Rehabilitation Trust (BIRT), a division of The Disabilities Trust.
This was our first inspection of the service since it registered with CQC in November 2017. At the time of our inspection the service was providing support to 47 people and employed 82 staff.
The service had an experienced registered manager. 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.
The service had systems in place to protect people from abuse and staff were able to explain what actions they would take in the event of a person being at risk of harm.
Staff were safely recruited and were supported with an induction process. This ensured that the staff the service recruited were safe, suitable and competent to work with vulnerable people.
Medication was correctly administered and recorded by staff who had appropriate training and experience. The staff we spoke with told us that they were confident managing people’s medication and people received the right medication at the right times. The people we spoke with told us that they received their medication correctly and when they needed it.
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 supported this practice.
Overall, staff were up-to-date with their training and there was a clear system to document, monitor and plan staff training. We saw that all staff had received training relevant to their roles and new staff were appropriately inducted into their roles.
People were supported to plan, buy and prepare the food and drink they wanted. One person said, “I like to cook my own meals, the staff help me to do this, they’re all really good.”
We saw that staff had developed well-established, caring and positive relationships with the people they supported. We observed many caring interactions between people and the staff when we visited them. One relative said, “There’s a lovely atmosphere at [relative’s home], the staff are all friendly and caring, they have a chat, have a cup of tea and have a laugh with [relative].”
We found numerous examples of staff supporting people to live as independently as possible and make their own choices. Examples of this included people being supported to complete day-to-day tasks such as cooking, cleaning and shopping.
The care plans we reviewed were person-centred and gave staff the information that they needed to safely and effectively meet people’s needs. One relative said, “The staff treat people as individuals. [Relative] is happy there, he relates to the staff and he’s settled living there.”
People’s care plans gave staff clear information on how to support people with any communication needs.
We saw that staff supported and encouraged people to enjoy activities, hobbies and interests that were important to them.
The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. This means that the people supported by the service who live with learning disabilities and autism could live as ordinary a life as any citizen.
Staff told us they felt well supported by the registered manager and were confident in their knowledge and abilities.
There were effective systems in place to monitor and assess the quality and safety of the service being provided. Staff also had access to a range or regularly reviewed policies to help guide and support them.