At the time of the inspection there were 19 children, young people and adults receiving a domiciliary care service and three people living in supported living accommodation. A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
Is the service safe?
We observed staff at the supported living service working with people in a way that respected people's rights and dignity. One person told us, 'The girls are good to me'.
Staff knew about people's risk management plans and used these to keep people safe. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives. One person told us, 'Staff have been helping me out with my moods.'
The systems in place ensured that accurate records were kept for administering medicines. This reduced the risk of harm to people.
People told us there was consistency in the staff that supported them. One relative told us, 'They shadowed people ' if someone new comes along they shadow. One staff came to shadow when they took (person) swimming. (Person) needs someone she knows.' This helped to ensure that people's needs were being met and they were kept safe. Two people told us that their usual staff had been absent recently due to sickness and no cover had been provided, leaving them without support. However, people told us this did not happen very often.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
Is the service effective?
People's health and care needs were assessed with them, and they and their families were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they reflected their current needs.
People who used the service and their relatives told us that they were happy with the care they received and felt their needs were being met. One person told us, 'They do what I want them to do.'
People and their relatives told us staff asked for their consent before providing care and that staff were good with communicating with them. One relative told us, '(Person) has limited understanding but (staff) communicates well with her. She reinforces what she needs with pictures and schedules.'
It was clear from our observations and from speaking with staff that they understood people's care and support needs well and worked in line with people's wishes.
Is the service caring?
We asked people and their relatives for their opinions about the staff that supported them. Feedback from people was consistently positive and people told us staff were 'brilliant', 'good to me' and 'we call Tracy (registered manager) Number 1'.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
We observed staff working in a caring and sensitive way with one person at the supported living accommodation and being led by them in the support they provided.
Is the service responsive?
On the day of the inspection we spoke to a psychologist who was employed by the provider and who was visiting one person because they were in a time of transition. Additional staffing had also been put in place on a short term basis to support the person. This meant that the service responded to changes in people's lives and needs and worked well with other services to make sure people received care in a coherent way.
We saw that people's care plans were reviewed regularly to ensure the care being provided was appropriate when people's needs changed. One relative told us, 'Tracy (registered manager) came the other week to update it now that (person) has changed school.'
Is the service well-led?
People using the service, their relatives and friends completed satisfaction surveys. Where shortfalls or concerns were raised these were taken on board and dealt with. One relative told us, 'They've never given me cause to complain. I do get questionnaires. I fill them in.'
Staff told us they were clear about their roles and responsibilities. Where issues arose these were escalated and actioned appropriately. People told us they felt able to raise issues with staff and the registered manager and felt these would be addressed. One person told us, 'If you want to change something, they change it. I've got no complaint with staff. I've said the odd bits to Tracy (registered manager). She goes off and talks to staff to sort problems out.'
The service had a quality assurance system in place, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.