We carried out a review of the data available to us about Focus Support Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Focus Support Limited, you can give feedback on this service.
At our last inspection in September 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Why the service is rated Good.
People were treated with care and kindness. They were consulted about their support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by people and the relatives who gave us their views. People were encouraged and supported to maintain and increase their independence.
People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable.
People received care and support that was personalised to meet their individual needs. They received effective care and support from staff who knew them well and were well trained. A community professional thought staff had the knowledge and skills they needed to carry out their roles and responsibilities.
People knew how to complain and knew the process to follow if they had concerns. People's rights to make their own decisions were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the supported this practice.
Where people were potentially being deprived of their liberty, the service knew to make the relevant commissioning authorities aware. This was so that commissioners could make applications to the Court of Protection for the appropriate authorisations.
People's right to confidentiality was protected and their diversity needs were identified and incorporated into their care plans where applicable.
People benefitted from a service which had an open and inclusive culture and encouraged suggestions and ideas for improvement from people who use the service and staff. Staff were happy working for the service and people benefitted from staff who felt well managed and supported.
Further information is in the detailed findings in the full report.
Support Partners provides supported living to people in two supported living settings and domiciliary care support to people in the community.
The service had a registered manager as required to manage its day to day operation. 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 and a relative felt staff were caring and supported people’s dignity and privacy. They felt staff involved them in making decisions about their day-to-day care and encouraged them to do what they could for themselves. Staff asked people’s consent before providing support and respected their wishes. People’s care needs were regularly reviewed with them.
Staff knew how to respond to signs of possible abuse and how to report it. They felt the registered manager would respond appropriately to any concerns raised.
People’s rights and freedom were safeguarded by staff.
The registered manager addressed complaints appropriately although records could have provided more information about the action taken to resolve them. The registered manager had sought people’s views about the service by means of a survey. Issues raised had been addressed. The outcome of the survey and the actions taken were reported back to people.
Medicines management systems were appropriate and all staff had their competency assessed periodically with regard to medicines management as well as infection control and manual handling. Where medicines errors had been made, staff had reported this immediately having first sought appropriate medical guidance on any necessary actions.
An appropriate recruitment process helped ensure that staff had the necessary skills and approach to care for vulnerable people. Some records were incomplete and this was addressed during the inspection.
Staff received an appropriate induction and there was a rolling programme of training to ensure this remained up to date. Their practice was monitored through a mix of spot checks of care practice, informal observation and through management working alongside them.
Staff were supported through supervision meetings and annual appraisals. Team meetings were not always frequent, limiting the opportunities for staff to discuss care practice with colleagues.
Management monitoring systems were in place. However, the monitoring that had taken place was not always recorded. The service had a development plan which identified goals and how they would be achieved.
Is the service caring?
Is the service responsive?
Is the service safe?
Is the service effective?
Is the service well led?
This is a summary of what we found:
Is the service safe?
People received care and support in accordance with agreed care plans. Appropriate professionals were involved in reviews as well as family representatives where relevant.
Where people had healthcare needs, the service had sought the advice of external healthcare specialists appropriately to maintain their wellbeing and safety. The provider had an appropriate system to manage medication safely where this was part of the care plan and staff received training on medication management.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). Following a recent Supreme Court judgement this legislation now applies to supported living settings. The manager was not aware of this judgement relating to 'deprivation of liberty' but undertook to make contact with the local authority DoLS team, regarding the implications, when notified of this during the inspection.
The parents we spoke with told us the service was well run and met people's needs. One parent said: 'they have never missed a call,' and one of the people supported told us; 'I am looked after properly.'
The provider had a recruitment and selection system and provided staff with induction, training and ongoing support and monitoring to ensure they provided safe and appropriate support.
Is the service effective?
We saw that people's needs were met by a well-trained team of staff and any changes in their needs were referred to management and acted upon. We heard that the people supported enjoyed positive relationships with and trusted the staff. The family members we spoke with told us the staff met people's needs effectively.
One of the parents we spoke with was pleased that staff were: 'supporting X's independence.' And another commented about staff treating their son as an adult. One of the people supported described the service as: 'really flexible.' And was happy that their support was provided by a core of regular staff.
Is the service caring?
We were told that staff worked in a caring and respectful way while supporting people. They enabled people to make decisions and choices and understood how they communicated. The staff we spoke with described supporting people to maintain their independence and how they enabled people to make decisions.
One person said the staff were: 'caring.' and added: 'I get on well with them.' A relative said: 'X enjoys being with them.'
Is the service responsive?
People's care files showed that the service responded promptly to changes in their needs or things they wanted support with. Appropriate advice was sought from external healthcare specialists when the need arose.
People and their relatives said the level and type of support offered was tailored to individual's needs and wishes.
We saw that the service had responded to act upon any issues raised in monitoring reports from external stakeholders as well as when issues had been identified internally.
Is the service well-led?
We found that the service provided consistent care to people and was well-managed. There were clear lines of managerial responsibility. Staff told us that managers were always available to them for support and monitored their performance.
The manager used a range of monitoring systems to maintain an overview of the agency's operation. The new computerised system monitored staff training and alerted the manager when courses were becoming due for updating. Action had been taken to address issues where these were identified. The views of the people supported and their relatives were sought and acted upon.
People were pleased with the way the agency was run and with the support offered.