Background to this inspection
Updated
23 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection took place on 28 and 29 June 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary service; we needed to be sure that someone would be in the office.
The inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert by experience contacted grandparents and parents of the children who used the service to obtain their views on the service.
Before the inspection we reviewed other information we held about the service and the provider. This included previous inspection reports and statutory notifications we had received from the provider. Notifications are changes, event or incidents the provider is legally obliged to send to CQC within required timescales. We also contacted the local authority commissioners for the service, the local authority safeguarding team and the clinical commissioning group (CCG).
During our inspection we spoke with four relatives. We spoke with four members of staff including the registered manager. We looked at quality survey responses to see parents and children’s views. We contacted four health and social care professionals to obtain their views of the service. We gained verbal information from two and written information from one health and social care professional.
We viewed a range of records about the young people’s care and support needs and how the service was managed. These included the care and support records of four young people, training, supervision and appraisal records for four staff, and records in relation to the management of the service.
Updated
23 July 2016
The inspection took place on 28 and 29 June 2016 and was announced. The last inspection of the service was February 2014, where the provider met all the regulations inspected at that time.
The Support Service for Disabled Children provided personal care to young people up to the age of 18 with a learning disability, physical disability, Autistic Spectrum Disorder or complex health needs. The support was provided in the young people’s home to assist parents to get their child ready for school or college, as well as providing support to reduce pressures on families. The service enabled young people to access the community as part of their leisure time support.
The service had a registered manager 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.’
Families were complimentary about the service and made positive comments. They were happy with the care and support their child received from the service. One parent told us, “The staff are very skilled.” Another commented, “They are absolutely amazing.” One young person had written a card to thank staff it read, ‘Thank you for looking after me.’
All support staff along with the manager had been employed by Sunderland City Council (SCC) for a number of years and their recruitment had been carried out by the Council’s human resources department. The Council’s procedure included relevant checks being carried out before staff commenced employment.
We found the service employed enough support staff to meet young person’s needs. One staff member told us, “We get a regular diary each week of our calls, we know just what we are doing.”
Staff were appropriately trained to support the young people who used the service. The service had an electronic system of e-learning for a range of subjects, such as health and safety. Further subjects included face to face training for moving and assisting, first aid and the Council’s own safeguarding training. Mandatory training was up to date for all staff. Staff felt supported in progressing their skills and knowledge, and received regular supervision and appraisal to aid their development.
Staff had an understanding of safeguarding and whistleblowing. They knew how to report concerns about young people’s care, health and wellbeing. Staff felt the manager was responsive and felt concerns would be acted on. The provider had a process of recording of all safeguarding alerts on a central system which showed appropriate action had been taken using a multi-disciplinary approach. Support staff were made aware of any changes from the manager if they were not directly involved in safeguarding meetings.
The provider had systems in place to manage complaints, accidents and incidents. Records were kept on a central system along with actions which showed the service responded to situations and lessons had been learnt from such events to reduce risk. Relatives knew how to make a complaint and were confident that the service would respond.
Risk assessments and support plans had been developed and reviewed with parent’s involvement. These included how staff were to support young people safely, detailing their likes, dislikes and communication preferences. The service worked closely with other teams in the Council to develop strategies to manage behaviour that may challenge.
The service did not provide support in the administration of medicines to young people. Any medicines administration would be the responsibility of the parent. One young person did have emergency medicine to take with them when they were in the community but were fully able to administer these themselves when they need to. Records showed that this was agreed with the parents and social worker.
Parents felt the service was well managed and that they were involved in decisions relating to the support of their child. Staff felt the manager was supportive. One staff member told us, “I am well supported by the manager.”
The provider followed their data protection policy and stored records securely. Records were also stored electronically and protected with a user password.
The provider had a range of quality assurance processes in place. Parents and the young person’s views were sought in assessing the quality of the service. Support plans were audited by the manager to ensure the information within was relevant, valid and current. Other management records such as policies and procedures were reviewed by the Council’s policy department. The manager had plans in place to increase the knowledge and skills of staff to support the increasing number of young people on the Autistic Spectrum who were accessing the service.