Personal Assistant Services North

Updated 22 August 2019

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

One inspector 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes, including supported living settings run by other providers.

The service had a manager registered with the Care Quality Commission. This means that 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 a short period notice of the inspection because we needed to make arrangements to speak with people and relatives and ensure we could access the service’s office.

Inspection activity started on 15 July and ended on 16 July. We visited the office location on 16 July.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

None of the people using the service were able to provide verbal feedback on the service. During our inspection one person visited the office and we observed the support provided to them. We received written feedback from one relative and spoke with seven relatives of people who used the service. We spoke with eight members of staff including two team managers, five support workers, and the operational quality director.

We reviewed a range of records. This included two people’s care records and one person’s medication record. We looked at one staff file in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at the service’s medication policy. We spoke with two professionals who regularly work with the service.

Updated 22 August 2019

About the service

Personal Assistant Services North is a domiciliary care service that provides support to people with a learning disability in their own homes. The service’s main aim is to provide support to people to enable them to access and engage with their local community and build their independence. This meant that 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. At the time of our inspection 13 people were receiving a regulated activity.

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

Governance processes and quality monitoring procedures did not always support the delivery of high-quality, person-centred care. We have made a recommendation about governance systems and processes. Improvements required to the governance systems in place also included the way in which the service monitored support with medicines. We have made separate recommendations regarding the monitoring and auditing of medicines and the implementation of end of life care planning. Whilst quality assurance systems required some improvements the team managers in the service had a good oversight of the support provided. The staff team were supportive of each other. They worked effectively between themselves and with external stakeholders and professionals.

Recent changes within the staff team meant at times the service had to use agency staff to ensure people received their commissioned service. This was managed with little impact to people using the service although some staff felt at times this had placed an additional pressure on them. People were safe using the service, risks were identified and responded to. Staff felt a commitment to the people they supported and understood the importance of reporting any concerns to the appropriate professionals.

Staff worked proactively with health and social care professionals which helped ensure the support provided was in line with best practice. People were supported to be healthy, this included supporting people to manage their weight or accessing health care services. Staff spoke positively of the training provided and the additional support given by the provider to make sure they could meet people’s needs. 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.

Staff were kind caring and supportive. Many had worked for the service for a long time and staff demonstrated a commitment to ensuring people received a good service and were treated well. Staff understood the importance of supporting people to have a say in their day to day support and enabled people to make decisions about this.

People received personalised care that met their needs and preferences. The support provided and the associated care plans were continually reviewed and updated. People’s communication needs were assessed and staff utilised various communication aids to support people’s communication. The service’s main aim was to encourage and engage people in their community, activities, work, and promote their independence. People were supported to engage in various activities that were of interest to them. The service had received no recent complaints. Relatives of people using the service told us they felt able to raise concerns if necessary and team managers were quick to resolve minor issues.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

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 (report published 17 November 2016).

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.