Future Directions CIC

Future Directions CIC provides care and support to people who live in supported tenancies. People live together in tenancies with a small number of other people. It supports people with a wide range of needs, including people with a learning disability, mental health needs, autism, dementia and acquired brain injury. At the time of our inspection the service supported 208 people, of whom 170 were supported with a regulated activity.

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

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 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.

Without exception everyone we spoke with was full of praise for the service and its staff. The service was driven by its five values: ‘put people first, be transparent, go the extra mile, be creative, be adaptable’. Through our observations and discussions with people and staff we saw that the service truly put these values into action.

People were treated with dignity and respect in a way that valued them as individuals. People were helped to set goals and staff supported them to achieve their dreams and aspirations and lead full and meaningful lives. People were helped to be as independent as they could be.

Staff worked with people to put together care plans that were person centred and achieved their desired outcomes. People benefited from support from small, consistent staff teams.

People were kept safe through robust safeguarding strategies. Staff were well-trained and received regular supervision to monitor their progress and ensure their work reflected the values of the organisation.

Staff were highly motivated and proud to work for an organisation which valued and praised its staff. There was a strong and knowledgeable management team who led by example and who were committed to continually monitoring and developing the service. The management team were passionate about the service. The service was forward thinking and innovative and worked creatively with outside organisations to promote the well-being of people with learning disabilities, autism, mental health needs, dementia and an acquired brain injury.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating at the last inspection of this service was good (report published 14 March 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 inspection programme. If we receive any concerning information we may inspect sooner.

Future Directions provides care to people who live in supported tenancies and who require a range of support relating to their learning or physical disability, sensory impairment or mental health needs. A multi-agency health and social care team is built around the service to provide on-going support to meet the social care and health needs of the people supported by the service. The service is based in Oldham, but provides support to people living in supported tenancies across the North West, including Greater Manchester, East Lancashire and South East Cheshire. At the time of our inspection the service supported over 220 people.

There was a registered manager in place. 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 registered manager was present during the inspection.

The service had a very strong value base which was reflected throughout the service. We were told that the service looked for people who shared the same values as the organisation when recruiting new staff, and wanted to ensure that staff were open and honest, creative and adaptable, and were willing to go the extra mile to put people first.

In order to recruit staff the service had developed innovative ways of seeking the views of people who used the service about the candidates’ suitability to work with people with learning disabilities. One person who used the service told us, “I interview for staff. We get most say about if the person is suitable for the job”.

We saw that when planning and reviewing services, the organisation had developed systems so that people who used the service had been consulted, and ensured that people who used the service were at the centre of everything they did. We saw a number of examples of how this was put into practice. For instance, they were involved in provision of training, and regular audits of service provision were carried out by a team of ‘experts by experience’ made up of people who used the service. They would inspect service delivery in supported tenancies, and feedback recommendations which the service would respond to.

During our inspection we visited eleven supported tenancies and saw that people were happy and content. They told us they were well cared for and involved in decisions about their lives. One person told us, “I am very happy with the support, especially around making choices. Yes, I am very happy here.” They were supported by committed and well trained staff with good interpersonal skills who had developed excellent working relationships with the people they supported. Where people had difficulty communicating, staff were patient listeners. They showed understanding of people's particular communication styles and how to interact positively with the people who used the service and demonstrated a good understanding of the background and history of people who used the service and were able to help them to consider their future options. People told us they felt safe. One person said, “I am safe here, the staff make sure of that”.

People were involved in drawing up and reviewing their own care plans which we saw were person centred and produced in a way the person could understand, for example, using pictorial representation or charts. In one supported tenancy we saw how the people had drawn up their goals for the year and produced wall charts to show progress on how these goals were being met. The service had established good links with healthcare professionals and ensured that people who used the service maintained good access to healthcare. Relevant professionals were invited to contribute to care plans, and health action plans addressed the health needs of people who used the service.

We saw that the service aimed to make people less dependent on support services and took a positive approach to risk taking. Risks were measured and agreed with the people who used the service. Where people who used the service did not have the capacity to make their own decisions, the service ensured that decisions taken were in line with the principles of the Mental Capacity Act 2005. Best interest decisions and any consultation undertaken were recorded as to why the decision was taken in the best interests of the person. One person who used the service told us, “They’ve helped me to be more independent and make my own choices”.

The service had systems in place to ensure that people were safeguarded from abuse, and promoted their whistle-blowing policy to allow members of staff to report any poor or unsafe practice. Where people presented with challenging behaviours which could result in harm to themselves or other people, a personal behaviour support plan was implemented. Plans helped the staff to recognise when individuals may be getting distressed, and identified more appropriate ways to help people get what they need. We saw that this had resulted in a reduction of the number of incidents of harm and minimised the use of reactive interventions.

Where possible people were supported to do their own shopping for food and received help to prepare their meals. Care records showed that attention was paid to what people ate and drank, and where people had been assessed as having a risk associated with eating and drinking, such as choking, specialist assessment and advice was followed.

We found the service was extremely well led with a highly trained and experienced management hierarchy to ensure effective communication, scrutiny and oversight of day-to-day activities and incidents. Robust systems had been developed to audit service delivery, and systems were in place to analyse information monitor complaints and issues, and identify trends and patterns.

The strong value base of the organisation was shared and demonstrated at all levels from personal assistants to the managing director, with all actions measured against the values of the organisation. Staff felt respected and valued in their role, and were encouraged to raise issues with their managers. They received regular supervision and yearly appraisal of performance, and attended team meetings where issues and practice could be discussed. They were rewarded at an annual event, which allowed the management team to acknowledge the work and commitment from the staff. Presentations were made and awards presented to staff who had helped achieve positive outcomes for people who used the service. This event allowed the management team to acknowledge the work and commitment from the staff.

The achievements of the service had also been recognised by a variety of national bodies, and Future Directions has won awards presented by national bodies such as Learning Disability and Autism Society, Skills for Care and other national and local bodies.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems for receiving, tracking and responding appropriately to complaints.

We spoke on the telephone with representatives of two people who received support. One representative told us that their relative was involved in agreeing their planned support. The other representative told us they had raised concerns and issues, which were responded to and resolved, but felt that the issues should not have occurred in the first place.

We saw that people were settled and 'at home', that they received individual, respectful support and responded positively to staff.

We saw that people were consulted about their care needs and their care records referred to their individual wishes and preferences.

We spoke with six staff. All demonstrated a good understanding of providing individual support to people and safeguarding them from abuse. Records were available of the training and personal development meetings staff had received.

Evidence was available that showed that regular checks or audits to make sure standards of care and service were maintained were undertaken.