This inspection took place from 26 July to 8 August 2018. We gave the provider short notice of our inspection due to the nature of the service. This was so the registered manager could be available to assist us with our inspection.This service provides care and support to 27 people living in various ‘supported living’ settings, which means that they can live in their own home as independently as possible. All of the people supported are living with either a learning disability and Autism Spectrum Disorders. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager who has been registered with CQC since May 2016. A registered manager is a person who has registered with CQC to manage the service. Like 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 last inspected the service in October 2015 and rated the service as Good overall. Since then we found that the provider and registered manager had closely considered the service and determined areas that they could develop further. We found that they had constantly challenged themselves and staff to develop a continuous improvement cycle so all worked to make sure people achieved the best possible outcomes.
We found the provider had instilled a positive culture within the service which meant people were given every opportunity to develop their skills and were supported through challenging situations. The provider aimed to go the extra mile to support people to engage fully with the community and lead ordinary lives, we saw copious amounts of evidence confirming this was the case. Staff were supporting people to lead lives that were enriched and full of opportunities. These experiences enhance their and other people's lives and shared the same values and principles, as the provider. For instance, people were encouraged and supported to be volunteers at the Alan Shearer Centre, which is a specialist recreational, sensory and social resource for disabled people of all ages. One person had been given an award by the Alan Shearer foundation for their services to the public, which was usually awarded to celebrities.
Staff were totally committed to delivering a service which improved the lives of the people who use the service in fulfilling and creative ways. Their drive and passion had created an exceptionally dynamic and vibrant service. Staff focused fully on the goals and aspirations of the people who used it. People told us the service provided care and support that was exceptional. They discussed how staff had supported them to develop their independent living skills and lead ordinary lives. The service was proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing. Staff actively supported people to engage in community activities and seek meaningful occupation. Some of the people told us how staff had actively supported them to find paid and voluntary work.
The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. People were supported to be as independent as possible and could access advocacy services if needed. Procedures were in place to investigate and respond to complaints.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff told us they received regular supervision and annual appraisals. Staff were respected within the organisation and were provided with a comprehensive range of training. We found staff were consistently striving for excellence and the provider supported them to achieve this goal by assisting staff to attend specialist training around working with people who lived with disabilities.
Staff worked collaboratively with people to assist them, to ensure their voices were heard by healthcare professionals.
Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities around safeguarding and staff had been trained in safeguarding vulnerable adults.
Care records showed that people’s needs were assessed before they started using the service.
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.
Appropriate arrangements were in place for the safe administration and storage of medicines.
There were enough staff employed to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. People who used the service were involved in this process.
The registered manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who used the service and staff feeling that they were integral and essential partners in the operation of the service. They constantly critically reviewed the quality of the service and routinely identified how they could enhance the service and ensure the staff remained at the forefront of best practice when working with the people who used the service. Their oversight of the service and encouragement of staff to keep abreast of developments and be innovative had led to excellent outcomes for the people who used the service and their relatives.
The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.