Chrysalis

Updated 7 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to two people living in their own houses and flats. It also provides care and support to six people living in a ‘supported living’ setting, so that they can live as independently as possible. 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 had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

We visited the office and the supported living setting on 4 February 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We met five of the eight people who use this service because we visited them in the supported living property. We met with five members of staff including the operations manager and support staff during our visit to the office. We also spoke with three further staff members when we visited the supported living property.

We contacted four professionals who regularly visit the service and a social work manager. We spoke with two relatives by phone after the inspection visit.

We reviewed a range of records. This included two full health and care files and six daily records. We looked at four staff files in relation to recruitment, staff development and disciplinary matters. We checked on medicines held in people's property. We reviewed a variety of records relating to the management of the service, including rostering of the care delivery.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received training data and quality assurance records.

Updated 7 April 2020

About the service

Chrysalis is a domiciliary care agency providing personal care to eight people living with a learning disability at the time of the inspection. Care is provided to two people who live in their own flats and to six people who live in one large supported living property. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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’s experience of using this service and what we found

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.The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People told us they felt safe and there were enough staff to support them on an individual basis. Risk was managed well so that people could be as independent as possible. Staff were appropriately recruited and staffing levels met people's assessed needs. Infection control was well managed and people supported to keep their homes clean and hygienic. People were supported to manage their medicines. The supported living service was still fairly new and the provider had continued to monitor the development of the scheme, learning all the time to ensure things ran smoothly.

The staff team were suitably trained and supervised. The registered manager ensured their practice was monitored so the team could continue to develop. For example there had been recent team meetings where staff discussed the progress of independence building and how they would put it into practice. Staff training covered all aspects of supporting people living with a learning disability. Staff had received training on specific needs of individuals and further training on up to date practice was underway. People were supported to be as well as possible, with routine visits to health care providers and a focus on exercise and healthy eating.

Staff displayed a caring attitude. They spoke about people in a respectful and empathic way. People responded warmly to the staff team and told us they were well supported. People in the service wanted to do more for themselves and the staff were working on individual goals that would increase independent living skills. People had regular reviews of their needs and had a say in the shared experiences in the supported living setting. People had access to advocacy and advocates had been involved, along with families when decision making had been complex.

Very detailed assessments of strengths and needs were in place and we saw very good care plans for individuals. People knew what was in their care plans and were happy with the goals they had set for themselves. Every person had daily and weekly planners and they went out to the gym, to socialise and to shop. People went to concerts and other entertainments; enjoyed spa days and went out for meals. No one had any complaints on the day and complaints and concerns were appropriately managed. Staff had not yet considered end of life considerations but this was in their future plans.

The team in the supported living had a well-respected team leader who reported to the registered manager. Together they led the teams who provided care to all eight service users. Staff understood the governance arrangements and also understood that quality was monitored on an on-going basis. Chrysalis had well defined values and a person-centred vision, supporting and encouraging people living with a learning disability to live meaningful lives.

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

Rating at last inspection

The last rating for this service was good (2 august 2017 published ).

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 re-inspection programme. If we receive any concerning information we may inspect sooner.