Background to this inspection
Updated
29 December 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 8 and 14 November 2017 and was announced. We gave the service 48 hours’ notice of the inspection site visit because we needed to seek permission to visit people in their homes and ensure they would be in. The inspection site visit activity started on 8 November 2017 where we visited eight locations. It ended on 14 November 2017 when we visited the office location to see the registered manager and office staff; and to review care records and policies and procedures.
The inspection team consisted of two adult social care inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with the registered manager, three supported living managers, six team leaders, ten support workers, 27 people who use the service and six relatives. We also looked at records related to the regulated activity of personal care including seven care plans, four staff files including information about recruitment.
We contacted also contacted 12 social and health care professionals and commissioners.
Updated
29 December 2017
Turning Point Oxfordshire provides care and support to 67 people living in 25 ‘supported living’ settings, 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. Not everyone using Turning Point receives regulated activity; 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.
We inspected Turning Point Oxfordshire on 8 and 14 November 2017. We gave the service 48 hours’ notice of the inspection to ensure the registered manager would be in the office. We also needed to let people know we wanted to visit them in their homes to review their support.
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.
People receiving support from Turning Point Oxfordshire received highly individualised person centred care. Support plans contained detailed and personalised care plans and we saw that many people had been supported to have a full and meaningful life enjoying interests and gaining employment. People benefited from a large range of activities and interests provided, to ensure they were kept occupied if they chose. There were many excellent opportunities to optimise people's social and stimulation requirements.
There was clear guidance for staff on how to meet people’s individual needs and support them to achieve their goals. We saw that people were relaxed and staff demonstrated a caring attitude. The service had ensured people’s communication was maximised which assisted an increased understanding and reduction of distress.
As the values and vision of the organisation and service had been integrated into everyday practice, people living with learning disabilities were able to achieve what they wanted in their lives and overcame obstacles to achieve positive outcomes.
People and their families, where appropriate, were fully involved in the development of their care planning along with health and social care professionals and Turning Point staff.
The service was outstandingly well-led. The service actively promoted a positive, inclusive and open culture. The structure of the service worked for people, so that locality managers were always available to support staff and people when needed. The service worked in conjunction with other organisations to improve care, such as participating in research and engaging in external initiatives working towards improving standards and developing the service further. There were robust quality assurance systems in place which monitored the service, identifying potential areas for improvement, and actions were taken to improve these.
Staff were highly motivated and worked as a team and shared a common ethos of providing high quality, compassionate care with regard to people's individual wishes and support needs. Staff were valued, well-supported and supervised by the management team.
Staff knew how to keep people safe, and how to report any concerns. There were enough staff to keep people safe. People received their medicines as they had been prescribed, and the service was undertaking an initiative to review medicines regularly, with a view to decreasing psychotropic medicines use.
Risk to people was identified promptly and effective plans were put in place to minimise these risks, involving relevant people, such as relatives and other professionals. Where risks were more complex, comprehensive guidance was in place to guide staff, including the most effective approaches to use, or particular communication methods suited to the individual. Guidance was in place for staff so that they could mitigate risk, and support people to take sensible risks as safely as possible.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had followed the Code of Practice in relation to the Mental Capacity Act 2005 (MCA). We observed staff treated people as equals and individuals, offering them options whenever they engaged with them. Staff always endeavoured to enable people to maintain their independence and to make their own decisions.
People's privacy and dignity were highly respected, and this also was reflected in the detailed guidance provided within people's care records.
People were supported to follow healthy diets, and this had a positive impact on their wellbeing. They were also supported to access healthcare services when they needed to.