The inspection of Outreach Teeside took place on the 23 June 2016 and was announced. We gave the registered provider 48 hours’ notice prior to the inspection. The registered provider was given notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The second day of inspection took place on 27 June 2016 and was announced. The location was registered in April 2014 and had not previously been inspected.
Outreach Teeside provides personal care to people in their own home. At the time of the inspection Outreach Teeside were providing support to 11 people. Six people were supported in a supported living setting and received 24 hour support and five people were supported in their own home. The office base was used to provide day support for these five people.
The registered provider had a registered manager in post. 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.
There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about the different types of abuse and what actions they would take if they suspected abuse was taking place. Safeguarding alerts had been made when needed.
Risk assessments were in place for people who needed them and were specific to people’s needs. Risk assessments had been regularly reviewed and updated when required.
Emergency procedures were in place for staff to follow and personal evacuation plans were in place for people that used the service.
Robust recruitment procedures were in place and appropriate checks had been made before employment commenced.
There were sufficient staff on duty. Relatives told us there were enough staff day and night to meet the needs of the people who used the service. Staff told us there was sufficient number of staff employed by the service.
The service had policies and procedures in place to ensure medicines were managed safely. However, medication competency assessments of staff administering medication did not take place on a regular basis. Medicine was not always stored safely as medication storage room temperatures were not checked or recorded.
Staff performance was monitored and recorded through a system of regular supervisions and appraisals. Staff had received up to date training to support them to carry out their roles safely and had completed an induction process with the registered provider.
People were supported to maintain their health through access to regular food and drink. Appropriate tools were in place to monitor people’s weight and nutritional health. Staff knew how to make referrals to health professionals should anyone using the service become at risk of malnutrition.
Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. However, people using the service had Court of Protection orders in place and deputy appointees but there was no documentation available to support this and the provider relied on obtaining this information from social workers.
People were supported to maintain good health and had access to healthcare professionals and services when needed. People made regular visits to their own GP.
From our observations, staff demonstrated that they knew people’s needs very well and could provide the support that was needed.
People and relatives were actively involved in care planning and decision making, which was evident in signed care plans. Information on advocacy services was available.
Relatives spoke highly of the service and the staff. People said they were treated with dignity and respect.
Care plans detailed people’s needs, wishes and preferences and were person centred. Care plans had been reviewed and updated regularly.
The registered provider had a clear process for handling complaints which we could see had been followed.
Staff described a positive culture that focused on the people using the service. They felt supported by the management. Staff told us that all managers were approachable and they felt confident that they would deal with any issues raised.
Staff were kept informed about the operation of the service through regular staff meetings. Staff were given the opportunity to recognise and suggest areas for improvement.
Quality assurance processes were in place. Managers from other locations and senior managers visited regularly to monitor the quality of the service.
Accidents and incidents were monitored to identify any patterns and appropriate actions were taken to reduce the risks.
The registered manager understood there role and responsibilities. Notifications had been submitted to CQC in a timely manner. Notifications are changes, events or incidents the registered provider is legally obliged to send us within the required timescales.