Steps to Independence Limited

Updated 27 April 2019

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.

Inspection team: The inspection was completed by one inspector.

Service and service type: Steps to Independence Limited is a small Care at Home service, registered to provide personal care to adults who live in their own homes. At the time of inspection, the service was providing personal care to five people with complex learning or physical disabilities in their own homes.

Not everyone using Steps to Independence receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had two managers 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.

We gave the service 48 hours’ notice of the inspection visit because it is small, and the managers were often out of the office supporting staff. We needed to be sure that they would be in.

Inspection site visit activity started on 28 March 2019 and ended on that day. We visited the office location to see the managers and to review care records and policies and procedures.

What we did: Before our inspection we reviewed all the information we held about the service, including changes, events or incidents that the provider is legally obliged to send us within the required timescales. We contacted professionals in local authority commissioning teams, healthcare professionals and safeguarding teams.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed this in advance of the inspection and used it to inform the inspection.

We spoke with four relatives over the telephone. We spoke with two members of staff: both registered managers.

We looked at two people's care plans, risk assessments and medicines records. We reviewed staff training and recruitment documentation, quality assurance systems, a selection of the service's policies and procedures, meeting minutes and maintenance records. Following the inspection, we contacted two members of support staff and one external healthcare professional.

Updated 27 April 2019

About the service: Steps to Independence Limited is a small Care at Home service supporting people to live independently in their own homes. At the time of inspection, the service was providing personal care and support to five people with complex learning or physical disabilities in their own homes.

People’s experience of using this service: The registered managers and staff successfully ensured people received high quality, person-centred care. They ensured people received a high quality of care from staff who knew them well.

The registered managers had been in place for several years and were supported by a small team of dedicated staff who were well trained and understood their roles. People’s relatives spoke highly of the registered managers, as did staff. They had backgrounds and experience relevant to the service.

Staff turnover was low and morale high. Staff had developed strong bonds with people and confirmed they were able to spend time getting to know people rather than focussing on tasks. All staff shared the provider’s vision of enabling independence for people in their own homes.

Staff received a range of relevant training, specific to people’s needs. They were supported by regular discussions with their manager and more informal support.

Records were accurate, up to date and person-centred. Oversight of these records and processes was strong and consistent. The registered managers demonstrated sound management of the service and clear plans in place to monitor and continually improve service provision.

People were supported to attend or take part in a range of activities and to try new things. Staff proactively encouraged people to live full lives and to maintain and develop their independence.

Medicines administration was safe and staff had the appropriate skills and knowledge. People were kept safe and staff were suitably trained in safeguarding principles and practice.

People’s capacity was assumed and staff acted in line with the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Appropriate training was in place.

The registered managers responded to any concerns or complaints and had appropriate policies and procedures in place.

Staff at all levels worked in line with the company ethos of promoting independence wherever possible.

The care service was managed in line with the values that underpin 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.

Rating at last inspection: We last inspected the service in June 2016 and rated the service good.

Why we inspected: We inspected the service in line with our scheduled programme of inspections.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk