MacIntyre Warrington

Updated 22 November 2018

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 14 and 23 August 2018 and was announced. We gave the service two working days’ notice of the inspection site visit. This was to help give notice to people who used the service that we would like to speak with them. We inspected the service and reviewed information at the registered location during both days of the inspection 14 and 23 August 2018. We arranged to meet people at the community café and arranged visits to people's own homes where they gave permission on the 14 August 2018. We met a variety of people who received support from each aspect of the service, including people living in supported living, people living with families as part of the "Shared lives" scheme, and people supported by their outreach support service known as "No Limits."

The inspection team consisted of two adult social care inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They supported this inspection by carrying out telephone interviews to seek the views and experience of people using the service.

Before the inspection, we reviewed the information we held on the service. This included checking if we had received any ¿notifications. A notification is information about important events such as accidents or incidents, which the ¿provider is required to send to us by law. We also invited the local authority and stakeholders to provide us with any information they held about the service. They provided very positive feedback. The provider completed a Provider Information Return (PIR). This is a ¿form that asks the provider to give some key information about the service, what the service does ¿well and improvements they plan to make. ¿

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with all three registered managers, two service managers, one administrator and 12 support staff. We spoke with 25 people being provided with support from all three services and nine relatives speaking on behalf of their family members. This gave us a wide insight into ¿their views across all areas of the service.

We also reviewed a range of records about people's support and how the service was managed. These included looking at support records for four people, medicine records, we reviewed four staff recruitment files, looked at staff duty rotas, staff training and ¿supervision records, a sample of minutes of meetings, complaint and safeguarding records, policies and procedures and a variety of records in relation to the management and governance of the service including examples of their innovation and developments.

Updated 22 November 2018

This comprehensive inspection took place on the 14 and 23 August 2018 and was announced. The registered provider was given 48 hours' notice of the inspection, to ensure that the registered manager or other responsible person would be available to assist with the inspection visit as well as giving notice to people who used the service that we would like to speak with them. This was the first comprehensive rated inspection of the service following their move of office and registration with the Care Quality Commission in December 2016.

MacIntyre Care is a national organisation providing care and support services for adults and children with autism, learning and physical disabilities. MacIntyre Warrington is registered with the Care Quality Commission (CQC) for personal care. It is situated in the centre of Warrington and supports adults and children.

The types of services offered from this location include supporting people living in their own tenancies in single occupancy or shared housing, supported living. This service provides care and support to people living in a supported living setting. 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 has been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen

Other services provided by the service, included people living with families as part of the shared lives scheme. They also provide an outreach support service available to people they support.

Not everyone using MacIntyre Warrington receives a regulated activity. CQC only inspects the service being received by people provided with 'personal care', help with tasks related to personal hygiene and eating. Where they do so we also take into account any wider social care provided.

The organisation has registered three managers at this location, each one has a specific responsibility for each of the services listed above. 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 service has sustained an outstanding level of person-centred care provided to people within all of the services listed above. People told us they received personalised support which was extremely responsive to their needs and requests.

Staff were clear in the ethos of the service to deliver person centred care to the highest standard. Stakeholders and members of multidisciplinary teams shared extremely positive feedback. They shared with us their views that the service was focused on providing support that achieves exceptional results and positively effecting people’s quality of life.

Staff were highly motivated, extremely kind and caring. Feedback from people being supported, stakeholders and families highlighted the care and compassion of the staff teams. People shared many examples of staff being caring and meaningful in their approach and of going above and beyond what might normally be expected of them in their role.

The registered provider, managers and staff showed they had an excellent understanding of people’s communications needs. They had organised different adaptions of information and training to meet people’s needs. They produced numerous examples of how they had been responsive to people’s requests.

Staff fully understood the importance of acknowledging people’s diversity. They made sure they promoted people’s rights including those with protected characteristics. Good practice was embedded and detailed in their policies and procedures. Staff demonstrated excellent values and innovation to always strive for further improvements in how they supported people’s diverse needs and requests. This was validated by the ongoing positive feedback collated all year round from people they supported

People were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible. Staff had followed the Code of Practice in relation to the Mental Capacity Act 2005 (MCA).

There is a transparent and healthy culture that encourages fun and creative thinking in relation to people’s safety. Health and safety was innovative and inclusive. They used accidents people had to try and avoid further accidents and shared these examples in ways that people understood and engage with. The service seeks out current best practice and uses learning from this to drive improvement for everyone.

The service supports people to have a full and meaningful life by using innovative ways to take positive risks and be actively involved in managing their own risks.

Comprehensive information and training was in place to guide staff, in the most effective approaches, which included positive behaviour support (PBS). This approach enabled staff to support people safely and reduce risks to the people they support. Auditing of this approach showed year on year improvements with exceptionally positive results to the quality of life for people they supported.

Recruitment procedures are driven by innovative practices. People being supported are key to the recruitment drive. They are at the centre of critical decision making in the services interview processes for recruiting new staff. Registered managers were confident their approach to recruitment helped attract the highest calibre of staff to the service.

The risk of abuse was minimised because there were clear processes, training and procedures in place to protect vulnerable adults. Safeguarding procedures were extremely well managed and lessons learned were shared with the whole organisation. The service worked in partnership with other organisations to ensure transparency and share good practices in safeguarding people within the service. People told us they felt very safe with the staff teams.

People who use the service are involved in regular reviews of how the service manages and responds to complaints. Processes are adapted in any formats necessary to help make sure people are fully included in all parts of a complaint investigation including conclusions and any lessons learnt.

Everyone we spoke with told us that the service was exceptionally well-led. The registered provider and registered manager use a variety of methods to assess and monitor the quality of the service. The organisation has a strong emphasis on continuous improvements. People being supported were at the heart of all areas of their quality assurance processes. Registered managers demonstrated with numerous examples how they reviewed their practices following people’s feedback and their inclusion in any changes and developments. Staff were proud of the visions and values of the service. They were highly motivated to contribute to continual improvements.

The registered provider took lots of opportunities to be inclusive with the communities where people lived to engage with many events and community initiatives. They often provided their own funding to develop innovative projects to put the needs and requests of people they supported at the heart of these projects. A strong emphasis was placed on engaging people in meaningful activity which met their individual choices. The projects were numerous and registered managers told us about continual initiatives to develop further suggestions to meet people’s needs.