Equal Partnerships is a domiciliary care and supported living service based in Longbenton, Newcastle. The service provides personal care and support to people living in their own homes, who have a learning disability and/or autism spectrum disorder. Some people also have a sensory impairment. At the time of our inspection 19 people received care from the service. At our last inspection in July and August 2014, the service was rated as ‘Outstanding'. At this inspection we found the service remained ‘Outstanding' and all the fundamental standards we inspected against were met.
This inspection took place on the 22 and 23 March 2017 and was announced. The inspection was carried out by one inspector.
Under this provider's registration with the Commission there is a requirement that a registered manager needs to be in post to manage the carrying on of the regulated activity at this location. One of the providers and owners of the company had taken on this role and they had been registered with the Commission as the registered manager of the service since December 2010. 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 other provider had assumed the position of nominated individual for the service as required by their registration with the Commission.
People's safety was paramount. Risks were appropriately assessed and managed. The service actively promoted positive risk taking so that people could live fulfilling lives, that were as independent as possible, whilst still remaining safe. People had been supported to travel independently within the community and arrangements were in place for staff to oversee that they did so safely. Staff had developed positive and meaningful relationships with people and encouraged them to overcome challenges and risks to achieve their goals.
People were encouraged and supported to manage risks within their own home environments. Regular checks on fire safety equipment and utilities were carried out, and servicing undertaken where necessary in line with best practice guidelines.
Safeguarding policies and procedures were in place to aid and guide staff about how to protect people from different forms of harm and abuse. Staff were fully aware of their personal responsibilities to safeguard vulnerable people in their care and they had no hesitation in reporting concerns. Any historic issues that had come to light had been dealt with appropriately and measures put in place to monitor and highlight any future concerns. The providers promoted an open culture and staff told us that any safety concerns raised at any time were dealt with very promptly by the providers.
Staffing levels were decided by people's needs, how they lived their lives and what support they therefore needed. Staff were structured in small teams supporting any number of individuals who lived in their own accommodations settings, some people shared houses, some people lived alone. Each staff team reported to a manager. All gaps in staffing for example, due to annual leave and sickness, were covered internally by other members of staff within the service.
The recruitment of staff was robust and appropriate vetting checks were in place to ensure that potential new staff were of suitable character to work with vulnerable people. People were actively involved in the recruitment process, as were their relatives. They drafted job adverts together with the providers and also interviewed potential new staff. Staff were appropriately inducted, trained, supervised, appraised and given opportunities for development. The providers told us they felt strongly that staff needed to be supported as much as people, so that they could give the best care and support possible. Regular assessments of staff competencies were also carried out to ensure their skills remained up to date. Staff told us they could not feel more supported on both a professional and personal level.
Staff were highly motivated and reflected pride in their work. They talked about people in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care possible for each individual. Each person in receipt of care had valued friendships and supportive relationships with the members of staff in the team that supported them and this had a positive impact of their overall health and wellbeing. It was clear that staff and people had similar interests and this added to their commonality and helped develop their relationships and understanding of each other.
Medicines were handled safely. People were empowered to be as independent as possible with the management and taking of their own medicines, but they were supported to check that this was done safely.
The care and support the service delivered was extremely effective and people, relatives, staff and healthcare professionals confirmed this in their feedback. Staff were extremely knowledgeable about people's needs and how best to support them. Their general healthcare and nutritional needs were met and monitored closely.
CQC monitors the application of the Mental Capacity Act (2005) and deprivation of liberty safeguards. The Mental Capacity Act (MCA) was appropriately applied and applications to deprive people of their liberty lawfully had been made to prevent them from coming to any harm where they lacked capacity. The service understood their legal responsibility under this Act. They assessed people’s capacity when their care commenced and on an on-going basis when necessary. Decisions that needed to be made in people’s best interests had been undertaken and records about these decisions were maintained. Records of associated capacity assessments were not always in place due the service not always being the completing party. We discussed this with the provider who assured us that in the future they would ensure that capacity assessments were obtained, or carried out internally for evidential purposes, if these were not forwarded to them.
The service had a positive, vibrant and caring culture which people, relatives and staff supported and promoted. People told us they were well supported and well cared for. One person said, "They are amazing. The staff are amazing!" All of the relatives we spoke with told us they trusted the staff and the service in general with the care of their loved ones. They commented that their family members had made significant progress whilst being supported by the service, and their lives, as well as their family member's lives, had been transformed. People were actively encouraged to maintain relationships with their families and friends and staff were passionate about supporting them in any way possible in order to remain connected to important people in their lives.
Staff were exceptional in supporting people to be as independent as possible in their lives. We saw lots of examples of where people were striving towards independence. For example, where people were capable and it was safe to do so, they signed their own medicine administration records and took responsibility for storing their medicines in their own rooms. People's dignity and privacy was protected and promoted by staff. Staff had been trained in equality and diversity and they explained how in their daily roles they protected, respected and promoted people's dignity.
People described how their care was delivered and what they told us demonstrated the service was extremely person-centred. Relatives and staff echoed that the service was person-centred in their feedback and our own observations and evidence gathered supported this. Every element of the approach of the providers and staff was centred around the people who used the service, their abilities, feelings, wishes and goals. There was nothing that the staff or providers themselves did not strive to overcome in supporting people to achieving and realising their aims. People's care records contained a range of information about the levels of care and support they needed to live their lives in the ways that they wanted to. These records were regularly reviewed and updated when people's needs or goals and aspirations changed.
People lived active, social and inclusive lives and this had a very positive impact on their health and wellbeing. The providers shared with us a number of moving stories about how staff had encouraged and supported people to achieve their goals in life. These ranged from a blind person driving a car, to people completing college courses and some going on to secure paid employment. Staff and the providers themselves were persistent in advocating for people to help them be the best they could possibly be. People were heavily involved in the community, they gave talks about disability at schools and worked with community groups to raise awareness about disability. In terms of activities people lived life to the full, going to the cinema, gym, friendship groups, theatre groups, swimming, shopping, cycling and running.
People, staff and relatives could not speak highly enough of the providers and their approach to leading their organisation. The providers themselves were focused, driven and extremely caring. They had a person-centred ethos, visions and values and this emanated down through the company. There was an open culture which resulted in the providers being fully aware of any issues or concerns within the service as they arose. People, staff, relatives and healthcare professionals engaged with them constantly to achieve a common goal of positive outcomes for people in receipt of care. The service worked with ease and in partnership with other organisations to support care provision, servi