Rainbow Support Limited Domiciliary Care Office

Updated 3 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector.

Service and service type

This service provides care and support to people living in two 'supported living' settings, so that they can live 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 service had a registered manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We announced the inspection a few days in advance to ensure that people would give us permission to visit them in their home. Before we visited the supported living settings, we discussed infection control processes for people, staff and inspectors, with reference to COVID-19.

What we did before the inspection

We reviewed information we had received about the service. We had contacted relatives, health and social care professionals and staff before the inspection to seek their views. We received five emails from relatives, six from health and social care professionals and 14 from staff. All were complimentary about the service.

We did not receive a provider information return as we had not requested it. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We met with five people in their supported living settings and support staff assisted us to communicate with them. We met with the registered manager and a senior support worker at the service’s office.

We reviewed two people’s care records. We looked at a variety of records relating to the management of the service, including policies, procedures and staff training and recruitment records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed the additional documentation we had requested from the registered manager.

Updated 3 November 2021

About the service

Rainbow Support Limited Domiciliary Care Office is registered both as a domiciliary care agency and a supported living service. It provides personal care to people living in their own houses and flats, and to people living in a 'supported living' setting, so they can live as independently as possible.

People's care and housing are provided under separate contractual arrangements. The CQC does not regulate premises used for supported living; this inspection looked at people's care and support. People using the service lived in two Supported Living settings in the west of Cornwall.

Not everyone using the service received a regulated activity; CQC only inspects the service being received by people who are provided with the regulated activity of 'personal care', for example which includes help with tasks such as personal hygiene and eating. Where they do, we also take into account any wider social care provided.

The service was able to support a maximum of 13 people but only 5 people received personal care. This included two people at Lauren House and three people at Cherry Trees.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

The Right support:

The model of care and setting maximised people’s choice, control and independence. The supported living settings were near to the centre of towns and had access to the local community and amenities. Staff supported people to make choices about their daily lives and engage in activities, that were tailored to their individual needs and promoted their independence. People were supported to maintain and develop relationships.

People were supported by enough staff on duty who had been trained to do their jobs properly. People received their medicines in a safe way. People were protected from abuse and neglect. People's care plans and risk assessments were clear and up to date.

Right care:

People received good quality person-centred care that promoted their dignity, privacy and human rights. There was a strong person-centred culture within the staff team. Positive behaviour support plans had been developed for people, to understand the reasons for their behaviour, and provide guidance for staff to ensure consistent approaches were used when supporting people. Staff knew people well and demonstrated an understanding of people’s individual care, behavioural and communication needs. This helped ensure people people’s views were heard and their diverse needs met.

Right culture:

People were supported by staff where the ethos, values, and attitudes of management and care staff ensured people led confident, inclusive and empowered lives. Staff created an environment that inspired people to understand and achieve their goals and ambitions.

People’s experience of using this service and what we found

The service had been open for a year. People, relatives and health and social care professionals were all complimentary in how the service supported people to ‘transition’ to their new homes. Comments included, ”This service enabled the person to move back to his heritage county after seven years of being away from family and friends. This was concluded during a pandemic, a difficult and unprecedented time. The move went with no instance and the transition was smooth and carefully planned” and ”I feel [person’s name] is in safe hands and feel very lucky to have found such a good setting for him.” A staff member commented, ”We all care greatly for the people we support. We aim to encourage their independence in every way that we can and be there to support them when we are needed.”

People had settled into their new homes and feedback from relatives, staff and health and social care professionals were positive in how people had developed their independent skills. Comments from relatives included ‘[Person’s name] has become a much more confident, independent and outgoing young man willing to try things he wouldn’t of tried before. His independence has astounded me with how he has come on with the support he has received from [the registered manager] and her team.

Staff’s in-depth knowledge of how people communicated ensured people had maximum control over their lives and how they spent their time. Care and behaviour support plans were accurate and kept under regular review, with the involvement of the person and their family. They provided staff with comprehensive guidance to ensure people’s needs were met. Risks were identified and staff had clear instructions to help them support people to reduce the risk of avoidable harm.

Staff were recruited safely. Staff were supported by a system of induction, training, supervisions, appraisals and staff meetings. Staff were appropriately trained, and their competency regularly checked, to ensure people’s complex needs were met.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID-19 testing for people, staff and visitors was being followed.

People’s relatives and staff told us management were approachable and they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to 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 and update

This service was registered with us on 2 September 2020 and this is the first inspection.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.