13 October 2016
During a routine inspection
4 Shanter Close is registered to provide personal care and support to people living in the community. The service specialised in providing flexible support to people with learning disabilities and autism who were living in two houses in Halifax. At the time of the inspection nine people were using the service.
At the time of our inspection visit the service was not being managed by a registered manager. The previous registered manager notified us of this change two weeks prior to our visit. 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. There was an acting manager in charge of the service; the acting manager had forwarded an application to register with the Care Quality Commission (CQC).
We last inspected the service on 24 January 2014 and found it was it was meeting all legal requirements.
All people spoken with told us staff were kind to them. People and their relatives indicated that they were very happy with the care and support provided and consistently described staff as going above and beyond their duty of care. People’s relatives told us the management and staff were extremely approachable, patient, available and willing to listen.
People were encouraged and supported to remain as independent as possible. Detailed and thorough risk assessments had been carried out to ensure their safety whilst enabling them to maintain their independence and lead interesting and fulfilled lives. We saw examples where photographs had been taken of actual equipment to help people and staff understand the risks involved in specific activities such as moving people.
The manager and staff had a high level of understanding of the need to make sure people were safe and were clear about what to do if they witnessed or suspected any abuse. We saw concerns had been reported promptly and appropriately. The recruitment process was robust and people were given the opportunity to be involved where possible.
There were always sufficient numbers of staff to ensure people’s individual needs and wishes were fully met. Staffing arrangements were flexible and people could accrue staff time to enable a member of staff to accompany them on specific events. People were supported by a consistent team of support staff. Staff told us they had sufficient time to support people on outings, holidays and activities and also time to support people who chose to stay at home.
Staff were creative in the way they communicated with people and used different methods such as scrapbooks, photo boards, picture planning, key words and iPads. This ensured people could express their views and were consulted about decisions and choices. It also helped staff to understand and respond appropriately if people were sad, happy or in pain.
There were safe arrangements in place to support people with their medication. We found good examples of how people’s health needs were pro-actively met and any changes in health were managed well. The service had good links with other agencies to ensure people received consistent, prompt and appropriate care and support.
Staff received a wide range of relevant and up to date training and induction and they told us the management team were always available for support and advice. They were motivated and passionate about providing exceptional care and support and achieving the best possible outcomes for people. Staff were very positive about working for the service and understood their responsibilities and the values of the service. Relatives felt the staff were highly trained, experienced and knowledgeable.
The manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and were dedicated in their approach to supporting people to make informed decisions about their care and making sure people’s human and legal rights were respected.
We observed staff had an excellent rapport with the people and we observed the positive interactions that took place. Staff spoke warmly and compassionately about the people they supported and treated people with kindness, care and respect. We observed people laughing and smiling and enjoying the attentions of staff. This showed they were comfortable and felt safe with staff.
Staff provided people with outstanding support which had a significant effect on enhancing their independence, confidence, self-worth and wellbeing. People were promoted to live full and active lives and were supported to go out and use local services and facilities. Staff were thoughtful about the choice of activities based on the person’s previous experiences and reactions. Staff spent time getting to know people and ensured activities were meaningful and reflected their interests and individual hobbies.
New people coming into the home were introduced gradually. They would visit the home and meet with support staff and with other people who lived there. One person had been sent electronic photographs of their bedroom, the house and the support staff to help with the transition process. Care and consideration had been taken to replicate their bedroom as far as possible to help them with the move.
Staff used creative methods to enable people to have a varied, interesting, healthy and nutritious diet. We found good examples of how staff had supported people with the management of healthy eating. Staff used picture menus and showed people different drinks and meals to choose from. People’s cultural and dietary needs were taken into consideration when planning and preparing meals. People’s dietary needs were monitored as appropriate and staff sought prompt professional advice in line with people’s needs.
People and where appropriate, their relatives were fully involved in identifying their needs and how they liked to be supported. People’s preferences were sought and respected throughout the whole care planning process. We saw people had a comprehensive person centred plan which they reviewed with staff support at regular intervals. Relatives told us staff provided consistent personalised care and support and said staff involved them in their family member’s lives at every opportunity and they felt part of an extended family.
The management team had a positive attitude to complaints and saw them as an opportunity to improve. People were actively encouraged to express their views on the service and voice any concerns. Relatives told us they were very confident any concerns would be quickly dealt with to their satisfaction.
Relatives told us the management team and staff placed people at the heart of the service. People, their relatives and staff thought the service was ‘organised’ and ‘well managed’. People’s views were sought about the service; results from the recent survey showed a very high satisfaction with the service.
The management team had signed up to a number of accredited schemes and had very good links with other agencies to continuously drive improvement in the service. This demonstrated how the manager continually strove to improve all aspects of the service.
There was an effective and thorough quality assurance system in place. We found regular quality audits and checks were completed to ensure improvements were continually recognised and the necessary action was taken to implement any changes. People using the service, their relatives and all staff were actively encouraged to contribute to the evaluation of the service and make recommendations for improvement.