Specialist Support Services for Younger Adults with Disabilities North

Specialist Support Services for Younger Adults with Disabilities North is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 36 people were receiving personal care from the service. This included people living in supported living settings.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

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.

People received care and support to maintain an environment that suited their needs and preferences.

Staff supported people to make decisions following best practice in decision-making. People were

supported to carry out their daily living activities and pursue their hobbies and interests.

Staff supported people to access health and social care services. Staff supported people with their

medicines safely and in their preferred way.

Right Care:

People received care that was person-centred. Their dignity, privacy and human rights were promoted.

Staff communicated with people in ways that met their individual needs.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service employed skilled staff to meet people's needs and keep them safe.

People's care plans reflected their needs and wishes and promoted their wellbeing. Risks that people may face were appropriately managed.

Right Culture: The ethos, values, attitudes and behaviours of the registered manager and staff team ensured people lead confident, inclusive and empowered lives.

People received good quality care and support because trained staff and specialists could meet their needs and wishes.

People and those important to them, including social care professionals, were involved in planning their care. The registered manager and the staff team ensured people received support based on best practice, respect and inclusivity.

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

The last rating for this service was requires improvement published 19 October 2021 and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.

This report only covers our findings in relation to the Key Questions safe, effective, responsive and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Specialist Support Services for Younger Adults with Disabilities North on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Specialist Support Services for Younger Adults with Disabilities North is a domiciliary care agency who are registered to offer support to older and younger adults with; physical disabilities, learning disabilities, autistic spectrum disorder and mental health. They provide personal care to people living in their own homes. At the time of inspection, the service was supporting 63 people with personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The service did not have enough staff to meet people’s assessed needs. Staff were working long hours with limited breaks to ensure care calls were completed. This had impacted on the personalised care people received. We were told that not all staff knew people’s needs.

Records of care tasks had gaps in the recordings, this meant there were limited assurances that tasks had been completed. However, people told us staff stayed the allocated amount of time.

Risk assessments and care plans were not all up to date and did not always contain sufficient information to ensure staff knew people’s needs. People did not always have a consistent staff team or know who was attending their calls due to the issues with staffing.

Medicine administration required improvement. We found concerns with the recording of medicines.

Systems and processes to ensure oversight of the service had not always been completed. The registered manager did not always have the time to complete the oversight required due to the issues with staffing.

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 did not always support this practice. People were not currently able to have the choice of gender or staff due to the issues with staffing.

Safeguarding systems were in place and staff knew how to recognise the signs of abuse. People told us they felt safe.

Staff wore appropriate Personal protective equipment (PPE) for the tasks they were completing. Staff took part in regular COVID-19 testing.

People were supported by staff who had been safely recruited, had sufficient training and who people described as “kind and caring.”

Staff supported people to access health professionals when needed. Any advice was recorded and acted upon.

People, relatives and staff knew how to complain and knew who the registered manager was.

People and staff were offered opportunities to raise any concerns in meetings or reviews.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• Staff encouraged people to make choices and to be as independent as possible. However, due to staffing issues choices in staff preferences were limited.

Right care:

• People were supported by staff who had a kind and caring nature. Staff promoted people’s dignity and privacy. People’s human rights were upheld.

Right culture:

• Ethos, values, attitudes and behaviours of managers and care staff ensure people using services lead confident, inclusive and empowered lives.

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 November 2018)

Why we inspected

This was a planned inspection based on the previous rating and was prompted in part due to concerns received about staffing and pressure care. A decision was made for us to inspect and examine those risks.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to risk assessment, medicines, oversight and staffing at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.