22 July 2014
During a routine inspection
We spoke with the registered manager, a team leader and three support staff. We also spoke with two people who used the service and reviewed three people's support plans. We reviewed a selection of other service records. These included the staffing rotas, the complaints procedure and the policy and procedure for safeguarding vulnerable adults.
We used the evidence we collected during our inspection to answer five questions.
Is the service safe?
People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. This included effective policies and procedures, mandatory safeguarding training for the staff and Disclosure and Barring Service (DBS) checks for employees.
Staff had received training in relation to lone working and there were policies and procedures in place to help staff reduce any risks associated with lone working.
The people who used the service had effective risk assessments in place to reduce the risks associated with the different activities they participated in. These included going out in the car, horse riding and sailing. The manager engaged with other health and social care professionals to help ensure that people's medical care needs were met.
There were enough qualified, skilled and experienced staff to meet people's needs. The team leader effectively deployed the support workers to care for people and there were arrangement in place to address any shortfalls in the staffing numbers
There were effective procedures in place investigate accidents and incidents and we saw evidence that appropriate actions were taken to help reduce the risk of repeat occurrences.
The provider had arrangements in place to manage foreseeable emergencies. These included adverse weather, loss of utilities and fire, including personal evacuation plans.
Is the service effective?
One person we spoke with said, 'I am very happy coming to the hub. I can do dancing here and I make my own cards.' Another person said, 'I am very satisfied with the care I get. The staff have enabled me to live relatively independently and participate in community activities. I can meet people again.'
People's needs were assessed, and care and support was planned and delivered in order to meet these needs. People and their relatives had been involved in making decisions about their care and support, and care plans were person-centred. Some of the people who used the service were not able to speak or had complex communication needs. The support workers effectively used different communication techniques that helped to ensure people understood what was being said.
It was evident that people's care and support enabled them to lead active lives in their own communities and maintain the level of independence that was right for them. People had chosen how they wanted to spend their time and people's days were structured to facilitate this. This included support workers helping people to achieve the goals that they had set for themselves. Examples of this included growing plants, baking cakes and meeting friends.
We noted that there was multi-disciplinary working and working with others. This included the involvement of people's speech and language therapists, their social workers and their general practitioners.
Is the service caring?
During our inspection we observed the interaction between the support workers and the people that they were caring for. It was evident that the staff knew the needs of people well. The care and support delivered was person-centred and promoted people's independence and self-care as appropriate.
The staff were attentive and compassionate towards people. They allowed people the time that they needed to express themselves in an encouraging manner.
The team leader told us that the support workers visited a person who used the service whilst they were an inpatient in hospital, in order to offer additional care and support for them. We spoke with this person and they told us that the staff had been very kind and caring during this time and had helped them to recover.
People's privacy and dignity were maintained at all times, and staff treated people with respect.
Is the service responsive?
Before people used the service the team leaders assessed whether both the service and the available staff could meet their needs. This included responding to people's request to have a female or male support worker, as well as people's requests for staff of a similar age and with similar interests.
People's support plans responded to all activities of daily living to help ensure that all of their needs were being met. This was reflected during our observation of staff supporting and caring for people. Included in this were activities that helped people achieve their goals such as being involved in the community, going to places of interest and undertaking domestic tasks.
The provider had a complaints policy and procedure. We noted that both verbal and written complaints were responded to in a timely manner and fully investigated. The results from complaints were fed back to the provider's governance board and the staff. This enabled learning to take place in order to improve the quality of the service provision.
Is the service well-led?
The staff we spoke with told us that they felt well supported by the registered manager and team leader. They told us that there were weekly staff meetings and that information about the service was shared with them.
We saw evidence of a positive culture and innovation within the service. During our inspection a support worker asked the team leader whether they could arrange a day out for people at a racing car event. They said that some of the people who used the service had expressed an interest in this. The team leader agreed to the event and offered their help or support to the member of staff.
The staff we spoke with understood their roles and responsibilities and knew when they needed to 'escalate' an issue or problem to the team leader.
The service had quality assurance systems in place to assess and monitor the quality of the service people received. At the time of this inspection a satisfaction survey for the people who used the service and their relatives was being undertaken.