Archived: Scarborough & District Mencap

Updated 6 October 2017

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

This inspection took place on 4 August 2017 and was announced. The provider was given notice because we needed to be sure that someone would be available at the office location to answer our questions and access records. Calls to people who used the service and relatives took place on 7 August 2017.

The inspection was conducted by an adult social care inspector. An expert by experience contacted relatives, via telephone on 7 August 2017. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of service. The area of their expertise was learning disabilities.

The provider had been asked to complete a provider information return (PIR) and this had been returned within required timescales. A PIR 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 used this information to help plan this inspection.

We reviewed other information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. We also sought feedback from the Local Authority.

During the inspection, we reviewed a range of records. These included four people's care records containing care planning documentation and daily records. We also looked at four staff files relating to their recruitment, supervision, appraisal and training. We viewed records relating to the management of the service and a wide variety of policies and procedures.

During the inspection, we spoke with eight members of staff including the registered manager, development manager and the Discoverers and the Flexi service managers. Following the inspection, we contacted seven relatives and two professionals by telephone to seek their views.

Updated 6 October 2017

This inspection took place on 4 August 2017 and was announced. The provider was given notice because we needed to be sure that someone would be available at the office location to answer our questions and access records

Due to the complex communication needs of people who used the service, we were unable to speak with them via the telephone. We contacted relatives on 7 August 2017 to ask their views of the service provided.

Scarborough & District Mencap registered with CQC in January 2011 for the regulated activity of personal care. The office is based in Scarborough. They are an independent charity that provide support to children and adults with learning disabilities. There were four services provided at the location. A day service for younger adults called Discoverers, a day service for older adults called Day care, a service that offered 2:1 or 2:1 support to people in the community or at the day centre called Flexi-support and a service for children who require 1:2 or 2:1 support called Flexi-care. Each service had a manager who was responsible for the day to day management which was overseen by the registered manager. At the time of this inspection, there were 20 people who were receiving support with personal care.

The four services were based at a day centre in Scarborough and provided people with the opportunity to participate in a range of activities and outings into the community. Evening activities such as a disco and a drama club were available which encouraged people to meet with friends and enjoy an active social life.

At the last inspection in June 2015, we rated the service as Good overall but identified that improvements were required in the well-led domain. We found that quality assurance systems that were in place needed to include a wider range of checks to ensure people were protected. At this inspection, we could see that further quality assurance systems had been implemented by the development manager for some areas of the service but this had not been cascaded throughout the service.

The service had a registered manager. 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.

The registered manager, who was also the CEO, was present throughout this inspection.

Recruitment procedures had been followed to ensure staff were safe to work and did not pose a potential risk to people who used the service. Interviews were recorded and records showed that the provider ensured new staff were suitable for the role before an offer of employment was made.

Medicines were managed and stored safely. When people required their medicines to be administered by staff, appropriate documentation and risk assessments were in place. Records showed that medicines had been administered as prescribed.

Safeguarding concerns had been managed appropriately. A safeguarding policy was in place to protect people from the risk of harm. All staff we spoke with were aware of the procedure to follow if they suspected abuse was taking place.

Risk assessments had been developed and were in place for people who needed them. They had been regularly updated to reflect people’s current needs .The service promoted positive risk taking and risk assessments recorded how this was to be managed safely. People were not restricted and their independence was promoted.

Relatives told us they trusted staff and felt people were safe in their care. New staff were given the opportunity to work alongside senior staff to build relationships with people.

Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005. Staff were aware of the procedure to follow if they suspected a person lacked capacity to make decisions and a policy to support this was in place.

There was a process for completing and recording staff supervisions and competency assessments. Systems in place ensured staff received the training and experience they required to carry out their roles. They completed an induction process and a range of training was provided to ensure staff were able to effectively carry out their roles.

Some people were supported by staff with meal preparation and where possible people’s independence was promoted in this area.

We found that relatives took responsibility for arranging medical appointments. Any concerns that staff had regarding people were recorded in daily notes and a handover to relatives was provided at the end of each day to ensure important information was communicated.

People were supported by a regular team of staff who knew their likes, dislikes and preferences. Staff had the knowledge of people’s personal histories and medical conditions. Relatives told us people were treated with dignity and respect.

The provider had an effective system in place for responding to people’s concerns and complaints. Relatives said they would talk to the manager or staff if they were unhappy or had any concerns.

Staff told us they felt supported by the management. They said the management team were approachable and they felt confident that they would deal with any issues raised. Staff were kept informed about the operation of the service through regular staff forums. They were given the opportunity to suggest areas for improvement.

The manager of the Discoverers service carried out a number of quality assurance checks to monitor and improve the standards of the service in areas such as medicines and daily visit reports. However, this had not been cascaded throughout the service and quality assurance processes in areas such as medicines and daily reports were not in place for the Flexi care service.

We have made a recommendation about effective quality assurance.

The registered manager had a good understanding of their role and responsibilities and had extensive experience of working with people with autism and learning disabilities. They understood when notifications were required to be submitted to CQC. Notifications are changes, events or incidents the registered provider is legally obliged to tell us about within the required timescales.

Further information is in the detailed findings below