Archived: RNID Action on Hearing Loss Northdown Road

RNID Action on Hearing Loss Northdown Road is a care at home service providing personal care to young adults with hearing loss and a learning disability in their own homes. There were eight people living in five houses, being supported by the service at the time of the inspection.

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

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.

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.

Potential risks to people’s health and welfare had been assessed and there was guidance in place to mitigate the risks to keep people safe. People were supported to take positive risks and take part in new activities.

Each person had a support plan that had details of their choices and preferences, staff had

detailed instructions on how to support people’s routines. These support plans were reviewed

regularly by the person, relatives, staff and healthcare professionals.

People were supported by staff who were recruited safely and received training that was required

to support people’s needs. Staff knew how to protect people from abuse and discrimination.

Checks and audits were completed to check the quality of the service provided. People and staff

were asked their opinions on the service and their suggestions about how to improve the service.

There was an open and transparent culture within the service. People were comfortable in the

company of staff and the registered manager, people were laughing and joking with the staff.

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 16 December 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.

RNID Action on Hearing Loss Northdown Road is registered to provide a domiciliary care and supported living service to support people who have a hearing loss and additional care needs. People who used the service were also living with a learning disability and or an autistic spectrum disorder. The agency covers Margate and the surrounding area. At the time of our inspection there were seven people receiving a supported living service.

A registered manager was 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. At the time of the inspection the registered manager was not available and was in the process of de-registering with us. The deputy manager had successfully been recruited to the manager position and was in the process of applying to become the registered manager. We will monitor this.

People were protected from abuse and avoidable harm. People who used the service told us that they felt they were supported safely. Staff had received training in safeguarding adults and were aware of their responsibility towards the people they supported. Staff were aware of the provider’s whistleblowing procedure and were confident in using it if required.

Risks associated with people’s health and well-being including safety issues within their homes, had been assessed and planned for. Staff had detailed information about how to manage and reduce known risks and these were monitored for changes. People had been involved in discussions and decisions about how risks were managed. They had copies of their risk plans that were presented in accessible communication format of their choice.

People who used the service were involved in the staff recruitment and selection process. The provider had safe recruitment processes that were followed to ensure as far as possible, only suitable staff were employed. Staff were carefully matched to people requiring support to provide the best outcome for people using the service. There were sufficient experienced and skilled staff available to support people safely and meet their individual needs.

People were involved in discussions and decisions about the support they required with taking their prescribed medicines. Staff had received appropriate training in medicines management. There were good systems and processes in place that supported people safely with the storage and administration of their medicines.

People were supported by sufficient and appropriately trained staff that were well supported.

Staff had received an induction and continued training and support, this enabled them to provide effective care and support to people who used the service.

People were involved in discussions and decisions about the support they required with taking their prescribed medicines. Staff had received appropriate training in medicines management. There were good systems and processes in place that supported people safely with the storage and administration of their medicines.

Staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005. This legislation is designed to ensure people are supported to make their own decisions wherever possible. People told us that they were consulted and involved in how they wished to be supported. Where people lacked mental capacity to make specific decisions about their care and support, MCA assessments and best interests had been made and recorded. However, the provider had relied upon external professionals to do this and needed to take this responsibility where required.

Where necessary people who used the service received support from staff to ensure their nutritional needs were met. People told us that they had a choice of what to eat and drink and that staff supported them with menu planning, shopping and cooking.

People received support to maintain their health and attend health appointments where required. When concerns had been identified in a person’s health, staff had made timely and appropriate referrals to external healthcare professionals for advice and support.

People were positive about the approach of staff and said that they had developed trusting and meaningful relationships with the staff that supported them. People said staff treated them with dignity and respect and that they were supported to live their life as they chose. People were supported to communicate in their preferred manner and staff had received training and support to enable them to communicate effectively with the people they supported.

Information about independent advocacy services were available for people should they have required this information. Examples were seen of how people had been supported to access this support or to maintain existing support.

People received a personalised service that was based upon their individual needs and wishes. Staff had received training in delivering person centred care and used a variety of person centred tools and approaches. This ensured people remained central in their care and support, this was empowering for people. People were supported with regular opportunities to review their support with staff. People had been asked about their personal goals and future aspirations and examples were seen of the achievements people had made with support from staff. People were supported to lead active and fulfilling lives which included building relationships and networks within the local community.

People were confident that they would raise any issues or concerns if required. People had access to the provider’s complaints policy and procedure in their preferred communication. Systems were in place for receiving, handling and responding appropriately to complaints.

Robust quality assurance systems were in place in order to ensure that people received high quality, safe and effective care and support. The manager of the service was continually exploring ways to improve the service. They showed a great commitment in providing a responsive service that was personable to each individual person they supported.

The service provided 24 hour support for 7 people who lived in their own homes. The service provided personal care, supported living services for people with hearing loss who may have additional care needs, such as a learning disability,

We also spoke with three people who use the service, the deputy manager and three support workers.

We found that people were asked to give consent and were involved in the decisions about the care and support they received. People told us and indicated that they were asked for consent before any care took place and their wishes were respected.

People who used the service told us and indicated that they were happy with the care and support they received. People were relaxed and responsive in the company of staff. They were able to let staff know what they wanted and we saw staff respond in a caring and positive way.

People said that there were enough activities and that they enjoyed going out in the local area and doing different things. People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and wellbeing.

People told us and records confirmed that medicines were given to people when they needed them and in a safe way.

We found that robust recruitment procedures were in place and staff received the training and the support they needed to fulfil their role.

People told us they did not have any complaints about the service. They were confident if they did the staff would take action to resolve any issues.

We were unable to speak to people who use the service at this inspection as they were unable to communicate over the telephone. We looked at other ways of gaining their views by looking at records kept by the agency and their systems for making sure people received a good quality of service delivered in the way they wanted.