We considered all the evidence we had gathered under the outcomes we inspected. We spoke with four of the people supported by the agency and two parents. We used the information to answer the five questions we always ask. Is the service caring?
Is the service responsive?
Is the service safe?
Is the service effective?
Is the service well led?
This is a summary of what we found:
Is the service safe?
People received care and support in accordance with agreed care plans. Appropriate professionals were involved in reviews as well as family representatives where relevant.
Where people had healthcare needs, the service had sought the advice of external healthcare specialists appropriately to maintain their wellbeing and safety. The provider had an appropriate system to manage medication safely where this was part of the care plan and staff received training on medication management.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). Following a recent Supreme Court judgement this legislation now applies to supported living settings. The manager was not aware of this judgement relating to 'deprivation of liberty' but undertook to make contact with the local authority DoLS team, regarding the implications, when notified of this during the inspection.
The parents we spoke with told us the service was well run and met people's needs. One parent said: 'they have never missed a call,' and one of the people supported told us; 'I am looked after properly.'
The provider had a recruitment and selection system and provided staff with induction, training and ongoing support and monitoring to ensure they provided safe and appropriate support.
Is the service effective?
We saw that people's needs were met by a well-trained team of staff and any changes in their needs were referred to management and acted upon. We heard that the people supported enjoyed positive relationships with and trusted the staff. The family members we spoke with told us the staff met people's needs effectively.
One of the parents we spoke with was pleased that staff were: 'supporting X's independence.' And another commented about staff treating their son as an adult. One of the people supported described the service as: 'really flexible.' And was happy that their support was provided by a core of regular staff.
Is the service caring?
We were told that staff worked in a caring and respectful way while supporting people. They enabled people to make decisions and choices and understood how they communicated. The staff we spoke with described supporting people to maintain their independence and how they enabled people to make decisions.
One person said the staff were: 'caring.' and added: 'I get on well with them.' A relative said: 'X enjoys being with them.'
Is the service responsive?
People's care files showed that the service responded promptly to changes in their needs or things they wanted support with. Appropriate advice was sought from external healthcare specialists when the need arose.
People and their relatives said the level and type of support offered was tailored to individual's needs and wishes.
We saw that the service had responded to act upon any issues raised in monitoring reports from external stakeholders as well as when issues had been identified internally.
Is the service well-led?
We found that the service provided consistent care to people and was well-managed. There were clear lines of managerial responsibility. Staff told us that managers were always available to them for support and monitored their performance.
The manager used a range of monitoring systems to maintain an overview of the agency's operation. The new computerised system monitored staff training and alerted the manager when courses were becoming due for updating. Action had been taken to address issues where these were identified. The views of the people supported and their relatives were sought and acted upon.
People were pleased with the way the agency was run and with the support offered.