Gemstone Care Limited is a domiciliary care agency (DCA) which provides twenty-four hour care and support across four supported living locations to people with a learning disability. At the time of our inspection eight people were using the service who were supported in their own homes.The inspection took place on 4th July 2016 and was announced. 48 hours' notice of the inspection was given because we needed to be sure that the registered manager would be available. The last inspection of this service took place on 6th December 2013 and at that time the service was meeting all the required standards inspected.
At the time of inspection there was a longstanding registered manager in post who was also the registered provider. '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 and associated Regulations about how the service is run.
The service was extremely well led. The provider demonstrated passion and dedication towards improving the lives of the people the service supported. Using their years of experience in the field of learning disability they were creative and innovative in their approach to support staff to empower people to lead meaningful and fulfilling lives.
Staff felt well supported by the provider who took a hands-on approach and was always accessible and visible within the service. A consistent support system of regular supervisions, appraisals and competency checks meant that staff felt confident and competent in their roles. A comprehensive programme of training was provided with opportunities for specialist training relevant to meeting the needs of the people and professional interests of staff.
The provider was highly valued by people, relatives, staff and professionals and was described as someone who always gave a hundred and fifty per cent. Despite actively encouraging people, staff and professionals to raise complaints or concerns, annual satisfaction surveys to monitor quality and drive improvements were relentlessly positive with the service described as 'brilliant' and ‘faultless.’
People felt safe and were happy at Gemstone as the provider had managed to strike the right balance between protecting people from harm whilst at the same time promoting their freedom and independence. People were given opportunities to take acceptable risks in their lives with the right level of support provided by staff. Activities were planned around what people wanted and not restricted because of the potential for harm.
Where necessary the provider took action to reduce any risk of harm whilst at the same time helping the person to do what they wanted. Any incidents or accidents were fully investigated with the emphasis on what could be learnt to reduce the potential for harm whilst not restricting people's personal development.
Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. People were supported to manage their medicines and be as independent as they could be. Safe recruitment practices were adhered to and there were sufficient numbers of staff employed to safely meet people’s needs. People were included in the recruitment process as their opinions and feedback regarding new employees was valued and acted upon.
Staff and the provider had an excellent understanding of the principles of the Mental Capacity Act 2005 and empowered people to make their own decisions wherever possible. People were supported to make choices about what they wanted to do in their day to day lives including exploring interests, education and job opportunities and maintaining and developing relationships that were important to them. Consequently, people’s confidence and abilities had grown since they started using the service. Relatives had noticed that people had become more assertive, making more decisions for themselves and had become much more independent and capable and were thriving under the nurturing care and support they received.
People received individual one to one support from staff and the provider so were able to take part in a wide range of activities that were important and relevant to them, both inside and outside of their homes. They were protected from social isolation because of the high level of support and opportunities made available through the service.
People received a high level of support to maintain their health and wellbeing. The service worked extremely effectively with healthcare professionals and were pro-active in referring people for assessment or treatment. The provider kept thorough and highly detailed health records and shared this information appropriately with relevant health and social care professionals. This meant that people’s health was closely monitored to ensure they received any treatment they required in a timely fashion.
Staff upheld the vision and values of the service which placed people at the heart of all that they did. Staff treated people with the utmost dignity and respect and looked for ways to help people feel valued and to promote their independence. This resulted in people forming very positive relationships with staff who were valued and held in high regard by the people and families they supported.
The care and support people received was personalised and tailored to meet their individual needs and preferences. People, and their representatives, where appropriate, were involved in making decisions about how the support was delivered so they felt listened to and included.
People were integral in shaping the service and making decisions about the way it was run. The provider and staff team recognised the importance of placing people at the heart of the service and empowering their involvement. There were effective systems in place to monitor the service and people benefited from an open and transparent culture where their views were sought and acted upon.
People were cared for by staff that knew them really well and understood how to support them to attain their goals. Staff respected people's individuality and encouraged them to live the lives they wanted. People's progress was monitored and celebrated.
The service was viewed as an organisation that went ‘the extra mile’, providing a level of dedication and commitment to the people it supported that often exceeded expectations. People were encouraged to express their hopes and dreams and the service looked for ways to make their aspirations a reality. .