Essential Care and Support Ltd

Essential Care and Support service provides care and support to people living in one ‘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.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people; respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to have choice about their daily lives. Not everyone being cared for expressed their needs verbally. The staff and the registered manager had a good understanding of people's responses and non-verbal communication. Staff had worked with people for a considerable time and knew them extremely well, including their likes and dislikes and personal preferences. People were able to access the community, if they wished and were supported to maintain good contact with their families.

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.

Right Care: Care was person centred and staff supported people to achieve their ambitions and live their best life possible. Staff spoke with understanding about the people they supported. People were treated with dignity and respect and staff had an in depth understanding of the person and the support they needed.

Right Culture: People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People’s care, treatment and support plans had clear guidance on what people’s goals and aspirations were. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. We received positive feedback from people and their family members about the service. Staff members were positive about working at the service and felt supported by the manager and the provider.

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 (Published 1 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to the length of time since the previous inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Essential Care and Support on our website at www.cqc.org.uk.

We have made recommendations about medicine records and audits regarding ‘as and when required’ medicines.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Essential Care and Support Limited is a domiciliary care agency based in Seaham, County Durham. It provides personal care and support to people living in their own homes or in small groups, referred to as an independent supported living scheme. Different levels of support are provided over the 24 hour period dependent upon people’s requirements. Many of the people are tenants of their home and pay rent for their accommodation which is leased from housing associations.

At the time of our inspection the service provided personal care to 95 people, the majority of whom required help to maintain their independence at home. CQC only inspects the service being received by people provided with personal care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Essential Care and Support Limited was last inspected by CQC on 22 October 2015 and was rated 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 risk 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.

People who used the service told us they felt safe. Relatives and external professionals expressed no concerns regarding safety.

The registered manager understood their responsibilities with regard to safeguarding. Staff had received training in prevention of abuse and were knowledgeable in recognising signs of potential abuse and the relevant reporting procedures.

Accidents and incidents were appropriately recorded and risk assessments relating to the environment and the delivery of care were in place.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Appropriate arrangements were in place for the safe management and administration of medicines.

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the people who used the service.

People who used the service, relatives and external professionals were extremely complimentary about the standard of care provided by Essential Care and Support Limited. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People who used the service received effective care and support from well trained and well supported staff. New staff completed a thorough induction into the service and mandatory training was up to date. Staff received regular supervision sessions and an annual appraisal.

Care and support plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. The plans made good use of personal history and described individuals care, wellbeing and support needs. Staff knew the people they were supporting and provided a personalised service.

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 service supported this practice.

The service demonstrated innovative practice with assistive technology which enabled people to gain more independence.

People were supported with their dietary needs and to maintain a healthy, balanced diet. People who used the service had access to healthcare services and were supported with their health care needs.

The service had a positive culture that was extremely person centred, open and inclusive. Staff felt supported by the provider and the management team, and were comfortable raising any concerns.

People were empowered to voice their views and feedback regarding the management of the service.

The registered manager showed us records confirming regular checks and audits were carried out at the service. The provider was meeting legal requirements in relation to notifying the CQC of events.

The service had excellent links with the local community and organisations.

The provider had policies and procedures in place that provided staff with clear instructions. Records were kept securely and could be located when needed.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. Two people told us they could share any concerns with the staff and felt their views were listened to.

Staff told us they were supported by the provider including training on the principles of care, safe working practices, and around the particular and complex needs of the the people who used the service.

During this inspection we spoke with the director of the service and the training manager. They told us training was on-going. We looked at the staff training records which confirmed staff had completed a range of training. This included training on risk assessments, report writing, challenging behaviour, autism, non-violent crisis intervention, dignity, respect, equality, deprivation of liberty safeguards and the Mental Capacity Act. We saw the majority of staff employed had achieved NVQ level 2 in care.

We also saw staff had annual refresher training in health and safety issues, for example, moving and handling and food hygiene and medication. This meant the service enabled staff to take part in training which was relevant and appropriate to their roles, so they could carry out their jobs effectively.

The training manager told us all staff had regular meetings with a senior member of staff. They included looking at the staff member's performance and any problems they had as well as achievements and training needs.

The manager told us they always ensured they carefully assessed the care and support needs of people wishing to use the service. All people their relatives, representatives' and health care professionals, where necessary were involved in this process. We saw detailed care plans, these described the actions staff needed to take to meet people's needs. This meant staff had the information they needed to support each person and keep them safe.

We found some accredited training for staff had not been kept up to date and this could compromise the care and welfare needs of people who used services.

Suitable arrangements were in place for handling complaints and for protecting people from harm. People told us they could share any worries with the staff and felt their views were listened to.

People told us they were very happy with the care and support they received.