Complete Care and Enablement Services

Updated 29 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

Two Inspectors, a member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Complete Care and Enablement Services is a supported living service. This service provides care and support to people living in ‘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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave short notice of the inspection because some of the people using it could not consent to a home visit from an inspector. We gave the service 24 hours’ notice of the inspection. Subsequent visits to different people’s home addresses were unannounced.

What we did before inspection

We reviewed information we received about the service. The registered manager sent us information relating to people’s addresses, communication needs and obtained consent from people and their relatives for us to visit or contact them. We sought feedback from professionals who work with the service.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two professionals who regularly visit the service, 14 members of staff including the registered manager, service managers, care staff and staff who administered medicines, six people who used the service and seven relatives about their experience of the care provided. We tailored our communications to suit people's preferences. We also observed people's body language and spent time observing people.

We reviewed a range of records. This included seven people’s care records and three medication records. We looked at three staff files in relation to recruitment, staff supervision, competency assessments and observations of practice records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 29 September 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Complete Care and Enablement Services is a supported living service providing personal care. At this inspection the service was supporting 178 people and can support up to 182 people in 23 different properties. Not all of these people received personal care and at the time of the inspection the service was providing personal care to 27 people. The service is also known as CareTech by most of the people who used the service and their relatives. The majority of people who used the service lived with a learning disability and/or complex mental health needs and were aged under 65.

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

Right Support

The service supported people extremely well to have the maximum possible choice, control and independence, and they had control over their own lives. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People and their relatives confirmed this.

People were supported to pursue their interests and to achieve their aspirations and goals. They could choose their living environment personalise their rooms. The service made reasonable adjustments so people could be fully involved in discussions about how they received support, including travelling to wherever they needed to go. Some had vehicles personalised to their needs; people chose how and when to use these to access the community and pursue their own personal interests People were encouraged to live full and active lives in the local community. With support they used technology and interacted with others who shared their interests’

People were supported to make the best decisions for them and communicated with others in ways that met their needs, often using voice activated technology. People were clearly delighted at the opportunities this presented. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. People played an active role in maintaining their own health and wellbeing.

Right Care

People’s equality and diverse needs were consistently promoted. Staff understood people’s individual needs and a multi-cultural workforce provided culturally appropriate care. Staff protected people from poor care and abuse and worked well with other agencies to do so. Staff could recognise and report abuse and there were enough appropriately skilled staff to meet people’s needs and keep them safe. It was clear staff cared deeply for the people they supported.

People told us staff knew them well and relatives also confirmed this. People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff and others involved in their treatment, care and support because staff had the necessary skills to understand them.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture

People led fully inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. It was very clear staff were enormously proud of the work they did in supporting people. People received exceptionally good quality care and support because trained staff and specialists who genuinely cared about people, could meet their needs and wishes.

People were supported by staff who fully understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received exceptionally compassionate and empowering care that was tailored to their individual needs.

Staff knew and understood people extremely well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff turnover was very low, which enabled people to receive consistent care from staff who knew them well. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care. An advocate and a health care professional confirmed this.

The service enabled people and those important to them to work with staff to develop the service and people were involved in interviewing and selecting new staff. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for the service at the previous office address was outstanding, published on 25 April 2019. The provider and registered manager had not changed.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

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.