Saracen Care Services Ltd

Updated 9 November 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager 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.

Notice of inspection

We gave the service prior notice of our inspection as some people using the service did not have the mental capacity to agree to a home visit from an inspector. The service needed time to complete the legal process for gaining permission on people’s behalf.

Inspection activity started on 2 September and ended on 5 September 2019. We visited the office location on 2, 3 and 5 September 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and observed the interactions of staff with four other people to help us understand the experience of people who could not talk with us.

We also spoke with eight relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, care director, two quality managers, a human resources manager, a training manager, two care managers, two senior staff and four care staff.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from seven professionals who regularly visit the service.

Updated 9 November 2019

About the service

Saracen Care Services Ltd provides personal care and support to people with a learning disability, physical disability and/or mental health need in their own home or in shared accommodation. At the time of the inspection, there were 25 people using the service.

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.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People continued to receive an outstandingly caring and well-led service. Following our previous inspection, the service had further developed their exceptional person focused approach and responsiveness to people’s needs. Staff viewed each person as individuals and we found people had been empowered, through creative communication, to make truly informed decisions that enabled them to live the lives they wanted. Highly motivated staff worked tirelessly to advocate for people and find solutions with people to negotiate the challenges they faced when making their life choices.

Since the previous inspection the provider and registered manager had continued to develop and improve the service. This had led to improved outcomes for people and excellent levels of support. Time and resources had been invested to develop a variety of accessible communication tools to support people to take control of their care.

People and their relatives spoke highly of the staff and the support provided. Without exception, people and relatives praised the staff for their caring attitude and their commitment to

support people. The staff valued and respected people decisions about how they wanted to lead their lives and the support they required. Staff understood the different and diverse needs of people and delivered care which was non-judgemental and promoted equality. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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.

Care provided by the service was person centred and focused on people’s individuals wishes and strengths. Staff had encouraged people to maintain their interests and relationships and be inclusive in the community. The provider supported people with the use of technology to assist people in communicating and understanding their needs and how to protect them from danger.

Comprehensive care plans were in place to provide staff with the guidance they needed to support people. Control measures and risk management plans were in place for people with specific medical conditions and others who were at risk of harm or harming others. People, where possible, were supported to understand the risk involved in any activities they were doing and how to stay safe. Health care professionals reported that the service was highly effective and responsive to people’s needs and that staff worked collaboratively with them to achieve the best outcomes for people. People’s medicines and finances were managed safely.

Safe recruitment practices of staff were used. The managers valued people’s feedback about the staff who supported them. All staff completed an induction programme and were trained in their role. Staff reported they felt supported and that managers were approachable. An effective on call system was in place to help manage out of hours concerns.

Complaints, accidents and feedback were taken seriously and used as an opportunity to improve the service. The registered manager had informed the CQC of significant events and managers worked openly and took prompt action to address any shortfalls.

There was an extremely positive ‘can-do’ culture within the service. The provider had a well-developed management system in place with clear responsibilities for every member of their staff team. The management team provided support to staff and a clear vision and strong values about how people were supported. The provider's governance was well-embedded and there were effective assurance systems that ensured ongoing compliance. There was a strong ethos of learning when things went wrong.

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 Outstanding (published 26 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.