Archived: Cheshire Branch Office

Updated 16 June 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 was planned to check 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 the 4,9,10 and 11 May 2017 and was undertaken by one adult social care inspector.

This was an announced inspection and we telephoned the service to give them notice of our visit. This was to ensure that someone would be available at the office to provide us with the necessary information to carry out an inspection.

Before the inspection we checked the information that we held about the service. We looked at any notifications submitted and reviewed any information that had been received from the public. A notification is information about important events, which the provider is required to tell us about by law. We contacted the local authority contracts quality assurance team, safeguarding staff and health and social care workers to seek their views and we used this information to help us plan our inspection. We will make reference to the feedback in the main body of this report.

The registered manager had not received a Provider Information Return (PIR) before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. However we gathered this information during our inspection.

We used different methods to help us understand the experience of people who used the service. By invitation we visited nine people who used the service in their own homes. During the inspection we spoke with a number of staff including the clinical director, the registered manager who was also the regional director, head of quality and operations, practice development lead, risk and governance lead, two integrated pathway leads, three integrated pathway coordinators, regional HR manager, recruitment team leader, safeguarding lead, four team managers and fifteen care staff. We looked at a number of records during the inspection and reviewed nine care records of people supported by the service. Other records reviewed included records relating to the management of the service such as policies and procedures, work schedules, complaints information and training records. We also examined six staff files.

Updated 16 June 2017

The inspection took place on the 4, 9,10 and 11 May 2017 and was announced.

This was the first inspection of the Cheshire Branch Office of Alternative Futures Group since it registered with The Care Quality Commission in 2016.

Alternative Futures supported living provides bespoke living solutions to people with different levels of housing support and care needs including young people in transition, people who live with autism, learning or physical disabilities, substance misuse issues, mental health and complex care needs. Their aim is to equip people with the essential skills needed for them to stay living independently in their home of choice for as long as possible. Support is provided by the Cheshire Branch office in a variety of settings over a wide area of Warrington, Cheshire and Wirral.

At the time of our inspection the service were providing supported living to 230 people within their own homes and providing outreach support to 32 people.

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.

People's medicine was stored and administered in line with best practice guidance which minimised the risk of people not receiving their medicines safely. Staff had completed medicine administration training and was aware of the actions they needed to take should an error occur.

People were supported by staff who had received training in how to recognise abuse and the actions they would need to take if they felt a person was at risk.

Staff had been recruited safely which included checks with the disclosure and baring service to ensure they were suitable to work with vulnerable people.

There were enough staff with the right skill mix to meet people's needs.

Staff received regular supervision and were supported to carry out their roles effectively.

Risks to people were assessed and staff understood their role in minimising risk whilst ensuring people's choices and freedoms were respected. Risks were regularly reviewed and when changes happened actions were carried out in a timely way. When appropriate this had involved the expertise of other professionals such as physiotherapists, occupational therapists and dieticians.

People were involved in decisions about their care. When they were unable to do this the principles of the mental capacity act were being followed. Advocacy services were available to people if needed. People had access to healthcare which included GP's, specialist learning disability nurses, health staff, dieticians and dentists.

Staff were caring and had warm friendly relationships with the people they supported. Staff attitudes were positive and they were described as respectful, patient and friendly. People's communication needs were understood by staff and this enabled people to be involved in decisions about their day.

Staff had a good understanding of people's interests likes and dislikes which meant they could interact in a meaningful way with people.

People's dignity and privacy was respected and staff encouraged and supported people to be as independent as possible.

People experienced care that was responsive to their needs and regularly reviewed.

Staff understood peoples care needs and how they liked to be supported. How people spent their time was linked to their interests and included activities both at home and in the community.

Daily records were completed by staff and reflected the care and support plans.

Communication passports were in place to for occasions when the person needed to be supported by another service such as a hospital admission.

The service had an open, friendly atmosphere and staff were positive about the organisation, their roles and the teamwork. We received mixed messages from staff about their overall responsibilities but in general they felt informed and appreciated and described communication as good.

The service had made statutory notifications to us as required. A notification is the action that a provider is legally bound to take to tell us about any changes to their regulated services or incidents that have taken place in them.

Audits had been completed by the management team and had been effective in providing data about practice and used to improve outcomes for people. Systems were in place that gave stakeholders an opportunity to share feedback about the quality of the service.

A complaints procedure was in place that families were aware of and felt that when they had raised concerns they had been dealt with appropriately.