Archived: West Cornwall Support Service

Updated 9 January 2019

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.

This announced inspection of West Cornwall Support Service took place on 16 and 22 November 2018. The provider was given short notice so arrangements could be made to enable us to visit people at home. The inspection was carried out by two adult social care inspectors.

We reviewed the Provider Information Record (PIR) and previous inspection reports before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also reviewed the information we held about the service and notifications of incidents we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we visited four of the settings where the service provides support. We met with seven people who used the service. We also spoke with three people’s relatives, six support workers, five service managers and the registered manager. Feedback was also received from a health professional who had previously worked with the service. In addition, we inspected a range of records. This included five care plans, seven staff files, training records, staff duty rotas, meeting minutes and the service’s policies and procedures.

Updated 9 January 2019

We carried out this announced inspection on 16,19 and 22 November. The service was previously inspected in April 2016 when it was rated as good in all areas. At this inspection we again rated the service as Good.

West Cornwall Support Service provides personal care to people living in their own homes in the community. It is a supported living service which aims to support people to 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. At the time of our inspection the service was providing support to 58 people with a learning disability living in Cornwall. The service provided support to people living in 15 different settings, three of which had previously been registered as care homes. On the days of our inspection 20 people the service supported were receiving personal care.

People told us they felt safe and well cared for. Their comments included, “I think the staff are wonderful” and “It’s nice and cosy[here].” While staff told us, “People are absolutely safe.” People’s relatives were also complimentary of the support the service provided and commented, “I know [Person’s name] is happy”, “The staff are all very caring” and “[My relative] gets on with the staff and laughs and jokes with them”.

All staff had completed safeguarding training and understood their role in protecting people from all forms of abuse and discrimination. Staff understood how to raise safety concerns outside the organisation but were confident any concerns they reported to their managers would be addressed.

The service employed sufficient staff to meet people’s needs and records showed planned levels of support had been provided. Staff told us, “There are enough staff” and “We tend to get cover even when staff are sick at the last moment.” Records showed the service was in the process of recruiting to fill staff vacancies. The majority of vacant shifts were normally covered by existing staff who knew people well.

Staff were well trained and knew how to meet people’s support needs. All new staff completed a comprehensive 12 week induction programme which incorporated the care certificate. Records showed training was regularly updated and staff told us, “The training has been good”.

Care plans provided staff with sufficient guidance to enable them to meet people’s support needs. Staff told us these documents were accurate and up to date. Staff comments included, “Care plans, I think they have all the information you need to work with people” and “There is enough information in the care plans for me.” However, we found people’s care plans included limited information about people’s life history and background. This issue had been identified by the service’s quality assurance system prior to our inspection and the registered manager told us this information was now being gathered from people and their relatives.

Risk assessments had been completed and identified the actions staff must take to ensure people’s safety. This included any environmental risks in people’s homes and any risks related to their care and support needs. Where risks had been identified in relation to people becoming anxious or upset, staff were provided with guidance on how to support people to manage these situations. Where appropriate staff had been provided training in the safe use of restraint. However, records showed these techniques were not regularly used and staff told us, “[Restraint] does not happen regularly. Staff would be very reluctant to do it. It would just be used to keep [the person] safe.”

All accidents and incidents that occurred were documented and reported to managers for further investigation. Records showed these investigations had led to changes to care plans and how support was provided. The service had learned from each incident and had made appropriate changes to its practices and people’s care plans to prevent similar incidents reoccurring.

Staff and managers understood the requirements of the Mental Capacity Act 2005 (MCA). Where people lacked capacity in relation to specific decisions these had been consistently made in the person’s best interest with appropriate involvement from relatives and health professionals. Some people who lacked capacity were unable to access the community without support from staff. The service had recognised these people’s care plans were potentially restrictive and had raised this with care commissioner for authorisation by the Court of Protection.

The service had robust recruitment procedures. Necessary checks had been completed to ensure prospective staff were suitable for employment in the care sector.

The staff team were well motivated and took pleasure in supporting people to live as independently as possible. Their comments included, “I think it works well as supported living” and “I enjoy working here it is a great team.” In one setting the service was supporting people to participate in a programme designed to develop bespoke assistive technologies to aid people’s wellbeing and increase independence.

Staff were well supported and had received regular supervision and annual performance appraisals from their managers. Staff comments in relation to their manager included, “[The service manager] is good, she is very ‘hands on’. I really like that if she says she is going to do something it gets done”, “[The service manager] is very good he knows his stuff” and “[The registered manager] is all right. She is really helpful. [The managers] are a good bunch always willing to help.”

There were effective quality assurance systems in place designed to drive improvements in the service’s performance. Regular audits had been completed by service managers and where any issues were identified, action plans were developed to ensure these issues were addressed and resolved

People and their relatives understood how to raise complaints and there were systems in place to ensure all complaints received were fully investigated and resolved. One person commented, “If any ‘funny business’ starts [the service manager’s name] sorts it out.”