Real Life Options - Teesside and Redcar Outreach and Supported Living

Real Life Options - Teesside and Redcar Outreach and Supported Living provides personal care to people living in their own houses and flats in the community. This support is provided through a supported living service and a domiciliary care service. The service supports young adults who live with physical disabilities, learning disabilities or autism spectrum disorders.

This service provides care and support to people living in three ‘supported living’ settings, and to one person in their own home, 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. Under the regulated activity, the service also provides domiciliary support to one person living in their own home.

Not everyone using Real Life Options – Teesside and Redcar Outreach and Supported Living 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. At the time of inspection 29 people were using the service, of which 18 were receiving personal care.

Services for people with learning disabilities and or autism are supported

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 lived in their own homes and their tenancies and accommodation was managed by a housing provider. The environment was suitable for people’s needs and changes had been made where needed to accommodate people. The design of the building enabled people to have their own space but also allowed people to have social contact with one another. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Staff understood and responded to potential risks. Safeguarding procedures had been followed. Incidents were recorded and lessons had been learned when incidents had taken place. Good recruitment procedures were in place. There were enough staff to support people safely. Hours were flexible to meet people’s needs.

People were supported in all aspects of their care. They had regular access to healthcare. Nutritional needs and preferences were respected and well managed. Staff received regular supervision and training.

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 by staff who knew them well. They were treated with kindness and their dignity was maintained. Staff respected people’s wishes and choices. People were actively involved in their care and were supported to be as independent as they wished to be.

People received person-centred care. Records accurately reflected people’s needs, and staff demonstrated good knowledge of these. People were supported to live fulfilled lives. People knew how to make a complaint. Where received, these had been dealt with appropriately. The service was equipped to support people at the end of their lives.

Managers at all levels were visible and staff were supported to deliver a good service. A continual system of improvement was in place which people were part of. The service was integrated into the local community.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (Published 31 July 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people with physical disabilities, learning disabilities or autistic spectrum disorders and older people.

Not everyone using Real Life Options – Teesside and Redcar Outreach and Supported Living 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. At the time of our inspection 16 people were receiving personal care.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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.

Staff received the training needed to provide effective support but the provider did not have effective systems in place to monitor and record this.

People and their relatives said staff at the service kept people safe. Risks to people were assessed and plans developed to reduce the chances of them occurring. The provider had contingency plans in place to provide support in emergency situations. Accidents and incidents were monitored to see if lessons could be learned to help keep people safe. Effective infection control policies and procedures were in place.

People were safeguarded from abuse. Medicines were managed safely. The registered manager and provider monitored staffing to ensure enough staff were deployed to support people safely. The provider’s recruitment processes reduced the risk of unsuitable staff being employed.

Staff were supported with regular supervisions and an annual appraisal. 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. People received the support they wanted and needed to manage their food and nutritional health. People were supported to access external professionals to monitor and promote their health. An assessment of people’s support needs was carried out before they started using the service to ensure the service could provide the support people needed.

People and their relatives spoke positively about the support they received from staff. People were supported to maintain their independence by using and enhancing their independent living skills and living as full a life as possible. Relatives we spoke with said staff promoted values of choice and independence. Support plans contained guidance to staff on how they could include people in the care they received and encourage them to do as much as possible for themselves. Staff told us they were committed to empowering people when delivering support. People told us they were treated with dignity and respect. Procedures were in place to support people to access advocacy services.

People and their relatives told us they received personalised care based on how they wanted to be supported. Support plans were based on people’s assessed needs and preferences. Some people received support to access activities and maintain and strengthen links with their local community. Policies and procedures were in place to investigate and respond to complaints. Procedures were in place to provide end of life care where needed.

People and their relatives spoke very positively about the registered manager and said the service had improved under their leadership. Staff also said the service had improved since the registered manager joined and that he was constantly driving improvement. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken. Feedback was sought from people and staff and was acted on.