Background to this inspection
Updated
18 March 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
One inspector
Service and service type
This service provides care and support to people living in [a] [insert number of] ‘supported living’ setting[s], 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 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 the service two days’ notice of the inspection in accordance with our current methodology for the inspection of this type of service. This enabled the service to seek people’s consent to talk with us by telephone. Inspection activity started on 19 February 2020 and ended on the 20 February 2020. We visited the office location on 19 February 2020.
What we did before 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. We took this into account when we inspected the service and made the judgements in this report. We reviewed other information we held on the service such as information shared by people or professionals. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager, a project manager and two support workers. We visited the home of one person who was supported by the service and their relative. Two staff were present during this visit and shared their views and experiences of working for the provider with us.
We reviewed a range of records. This included two people’s support plans and two staff files. We reviewed staff supervision records and a variety of other records relating to the management of the service, including the many audits carried out.
After the inspection
We spoke with a further three members of staff and another relative. We reviewed information sent to us during the inspection regarding staff training.
Updated
18 March 2020
About the service
Accomplish is a community service that provides care and support to adults of all ages in their own homes.
This includes people with learning and physical disabilities. The service provides some 24-hour live-in care
for people in their own homes. The service also provides outreach support for people who require support
with accessing the local area and work placements. At the time of this inspection the service was supporting
36 people.
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 not easily able to express their views verbally. We spoke with relatives to gather their views of the service provided to their family members. People were consistently positive about the service provided. Comments included, “We are selling our home and are specifically not moving out of the area covered by Accomplish as we don’t want to lose them” and “They [support workers] are absolutely marvellous. They have turned [Person’s name] life around as well as ours. They have saved us all. Everything and anything they need they get.”
Staff were innovative in ways of supporting people with their specific needs. Activities were varied and person centred. People were supported to socialise with friends in their local community. People experienced an improved quality of life with positive outcomes due to the support provided by the service.
People received support from small teams of motivated staff. Staff told us, “I love my job, I have never worked for a company like it, they are very supportive. Help is always at the end of the phone if you need it” and “We consistently support the same people in a team, my team is stable and rarely changes.”
Families and healthcare professionals were complimentary of the service performance and said, “What can I say but just fantastic. [Person’s name] is now a very happy and contented chap,” They now have new meaning to their life. We know they really looks forward to their trips out each day, “Thank you so much it has not only changed A's life it has changed our lives in a big way as well" and "Brilliant great work, please tell the team from us that they are amazing."
Records demonstrated people received their medicines on time and staff understood and met their needs. Information about people’s needs and preferences were recorded in support plans and staff used this information when planning how to support people.
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.
Risks were identified, assessed and reviewed. Staff were provided with guidance on how to manage and mitigate risks while providing support. The service had appropriate procedures in place during periods of adverse weather.
There were enough staff available to provide all planned support. No one reported having experienced a time when staff did not arrive as planned. All necessary recruitment checks had been completed for new staff. New staff completed an induction which involved training and a period of ‘shadowing’ more experienced staff. Training was refreshed so staff were up to date with any changes in working practices.
Support plans were in place for everyone using the service. People and their relatives were involved in the development and review of support plans. The service used an electronic system to hold details of people’s needs but also printed off paper copies for peoples’ homes and the office. The information generated by this system was accurate, timely and detailed.
Families told us staff were caring and treated their family members with dignity and respect. Information about people’s diverse needs was included in their care records. People and their families were supported to express their views to staff and management.
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.
People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Specific support was being provided to some people to help them overcome their anxiety of being treated by healthcare workers such as doctors and dentists.
Staff were well motivated and there was a positive open culture within the service.
There was a complaints process accessible to everyone. Records showed action had been taken to address and resolve any issues reported to managers.
The service was well led. Management roles were clearly defined and there were effective quality assurance processes in place.
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 26 September 2017)
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.