Supported Living (Cornwall) is a domiciliary care agency that provides personal care and support to people with a learning disability or a mental health condition in their own homes. At the time of our inspection the service was providing 24 hour supported living services to four people. A supported living service is one where people live in their own home and receive care and support to enable people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The care 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in post who was responsible for the day-to-day running of the service. 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.
We carried out this announced inspection on 16 January 2018. At the last inspection, in October 2015, the service was rated Good. At this inspection we found the service remained Good.
People we spoke with told us they felt safe using the service and said they trusted the staff who supported them. People were extremely satisfied with the quality of the service they received and the caring approach from staff. People said about the service, “Staff are good”, and “They are the best support workers I’ve ever had. I’m just so glad I met them.”
Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.
Staff were aware of the reporting process for any accidents or incidents that occurred and there was a system in place to record incidents. Where accidents, incidents or near misses had occurred these had been reported to the service’s managers and documented in the service’s accident book.
People were supported by dedicated teams who were employed to work specifically with each person using the service. People told us they were never supported by someone they did not know. People told us “Staff in my team do a brilliant job.” Some people were involved in the recruitment of staff in their teams.
Staff were recruited in a safe way and available in sufficient numbers to meet people’s needs. Staff were supported by a system of induction, training, one-to-one supervision and appraisals to
ensure they were effective in their role.
People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly.
People told us they had “never” experienced a missed care visit. The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service’s visit schedules were well organised and there were a sufficient number of staff available to provide people’s care visits in accordance with their preferences.
There were processes in place to protect people and the security of their home when they received personal care, for example having access to personal protective equipment and carrying identification. People had a copy of the staff rota so they knew who would be delivering their care and aware of who was due to call upon them.
People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act.
Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them in any way. People’s legal rights were understood and upheld.
Everyone told us staff ensured their dignity and privacy was promoted.
Staff were respectful of the fact they were working in people’s homes. The service offered flexible support to people and were able to adapt in order to meet people’s needs and support them as they wanted.
People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person’s individual needs and wishes. The service’s risk assessment procedures were designed to enable people to take risks while providing appropriate protection.
The registered provider and management team provided clear leadership to the staff team and were valued by people, staff and relatives. There was a shared team culture, the focus of which was how they could do things better for people.
People and relatives all described the management of the home as open and approachable. People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.