Archived: PICAS

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. The service supported people with learning disabilities and/or autism in line with these principles.

People lived in houses and flats in residential areas within or nearby town centres. The properties fitted into the residential area and other domestic homes of a similar size.

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

The service was safe. There were procedures to protect people from abuse. Risks associated with their needs were assessed and staff understood how to reduce these risks.

People were supported with their medicines. Staff were trained and competent in administering medicines to people. Staff followed infection control procedures. There was a procedure to review accidents and incidents in the service to learn lessons and prevent reoccurrence. Recruitment procedures were followed safely and new staff had their backgrounds checked to ensure they were safe and suitable to work with people.

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.

Staff felt supported by the registered manager. Quality assurance systems included checks on people’s care and obtaining feedback from people and relatives. The registered manager collated feedback to help make improvements to the service. However, we have made a recommendation for the provider to review how policies and procedures in the service are kept up to date because we found they were not always in line with current guidance.

Staff were supported with training and development to increase their skills and knowledge. People were supported with maintaining their health and nutrition. The service worked in collaboration with health care professionals, to ensure people's health needs were met.

Staff were kind and caring towards people. They respected people’s dignity and privacy. People were encouraged to be independent and go about their daily lives and routines. Staff understood the importance of promoting equality and diversity. People were supported to maintain relationships and a private life.

People received person-centred care and support. Their care plans were personalised according to their wishes and preferences. People were supported to pursue hobbies, interests and vocations of their choice, including finding part time work and educational courses. People were protected from social isolation. Staff communicated with people appropriately according to their communication needs. People and their relatives were supported to make complaints if they had a concern or were not happy with the service.

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 5 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

At our last inspection on 3 March 2016, we found four breaches of legal requirements. People who used the service were not sufficiently protected from the risk of abuse and their human rights were not always protected. We also found shortfalls with ensuring people received care that was responsive to their needs and notifying the Care Quality Commission of incidents that occurred within the service.

We undertook this inspection to comprehensively look at the whole service again and to check that they were now meeting legal requirements.

PICAS provides a supported living service to people living in their own homes in the London Boroughs of Redbridge, Newham and Hackney. Some people received personal care. At the time of the inspection, there were ten people were using the service. People either lived on their own or shared their accommodation with another person who used the service. The accommodation was maintained and owned by private landlords, who provided people with a long term tenancy agreement. People were visited and supported by staff from PICAS or had staff stay with them in their homes.

The service had a registered manager. 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.

We found that the provider had taken action to improve the service and we were assured that fundamental standards of quality and safety were being met. We advised that people’s records should be unique and individualised so they are not confused with another person.

People were supported to maintain healthy diets and ensure their nutritional requirements were met. They had access to treatment from health professionals and staff contacted them in emergencies.

There were recruitment procedures in place and staff were recruited safely. However, we have made a further recommendation about the provider’s recruitment processes. People were prompted to take their medicines as prescribed.

Staff respected people's privacy and choice. They told us they had support, training and supervision. They had knowledge of safeguarding and whistle blowing procedures and were able to describe the steps they should take to protect people from abuse and how to report incidents of abuse. We also recommended that there is more effective communication with local authorities when sharing information.

Records showed staff regularly attended staff meetings with the management team.

Where able, people made their own decisions regarding various day-to-day tasks including choices of food, activities and daily routines. There were systems in place to implement the requirements of the Mental Capacity Act 2005 (MCA) to ensure people’s human rights were protected.

Each person had a care and support plan which stated their support needs. The plans were regularly reviewed to reflect any changing needs.

People and relatives told us they knew how to make a complaint. They said staff listened to them and they were happy with the way the registered manager responded to complaints.

The registered manager had systems in place for auditing and monitoring the service to ensure quality was being maintained. People's finance and medicine records were regularly checked. A survey questionnaire was distributed to people, their relatives and social care professionals to ask them for their opinion about their experience using the service. The registered manager analysed and responded to any feedback to help improve the service.