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Support Solutions (West Sussex)

Overall: Good read more about inspection ratings

Units 3 - 4, 20 Northbrook Trading Estate, Northbrook Road, Worthing, BN14 8PN (01903) 866959

Provided and run by:
West Sussex Care Services Limited

Report from 12 March 2024 assessment

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Well-led

Good

Updated 17 April 2024

At the last inspection, we found the provider in breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulation Activities) Regulations 2014. The provider had not ensured there were systems and processes that enabled them to always identify, assess and mitigate risks to the health, safety and welfare of people. At this assessment, improvements had been made with quality assurance systems to ensure that there was oversight over the risks to people’s health and safety. The registered manager had worked to promote an inclusive service, improved the culture of the service and improved oversight of care through consistent and robust quality assurance systems. People and staff spoke positively about the registered manager’s approach.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Shared direction and culture

Score: 3

With regards to the mission statement and values of the service, the registered manager stated, "It's written on every email. When staff come in for supervisions, they are asked how they incorporate the mission statement into their day to day working and how they feel they do that." Staff spoke positively about the culture of the service. Staff spoke about the small staffing team and support from the registered manager. One staff member said, "It is good, we always mingle with our supervisor. The registered manager, she's like a friend.

The registered manager showed a focused approach in ensuring people received good quality care. Equality and Diversity training was in place for all staff to complete as part of their core training and completion compliance was high. Ethnicity, religion and sexual orientation captured within peoples care plans. Records showed that consistent and regular supervisions were undertaken, while inclusive staff meetings were held so staff could provide feedback and contribute. Managers and staff understood the diverse needs of the people they supported. The providers PIR confirmed they supported a person devout to their faith where certain aspects of their daily lives need to be appropriately observed and followed. Staff worked with the person and their family to arrange calls so they did not interrupt or interfere with those beliefs and practices. Conversations with the registered manger confirmed this.

Capable, compassionate and inclusive leaders

Score: 3

Staff spoke warmly about the manager, their approach and the support they provided to them. One care worker said, "She's a friend. If you do mistakes, she supports you and check whether we have corrected things. She always communicates. She's just a nice person." Other comments included, "She always listens to any issues we have." Another care worker said, "She is a good manager, hands on. If you are short. Yesterday I was struggling in (persons home) and she came straight down. She will jump on board of someone is off sick." One worker said, "You feel part of the company. She does listen to our concerns she you feel included."

The registered manager was knowledgeable about issues and priorities for the quality of care of the service. They appeared engaged, relaxed and confident with staff who visited the office. Risk assessments, whether health, mobility and environmentally based, were detailed and person centred, and demonstrated that the registered manager managed risks well. The registered manager had full oversight of the quality of the service, through monitoring of people's induction and probationary period, personally completing recruitment processes, shadowing visits and spot checks. The registered manager worked closely with the care coordinator during the site visit to address any issues that came through. The registered manager been involved in the care industry for several years and had extensive experience in domiciliary and residential care.

Freedom to speak up

Score: 3

The registered manager was confident that staff had the confidence to raise issues directly with them, and that systems were in place for staff to report wider concerns confidentially. The registered manager said, "They raise it with me in first instance. If it's anything to do with the registered manager, it goes to the appropriate person. There is a separate HR within the franchise for issues if they involve the registered manager. Staff can go direct to HR." Staff spoke positively about being able to speak freely and having their voices heard. One staff member said, "We can always say our grievances. We don’t have problems." One staff member said, "I raise issues. They take them on board." Another staff member said, "(The manager) responds positively so you feel open to say out your views."

The registered manager encouraged an open service and office where staff could raise any issues about care and their roles. Staff were able to raise concerns directly with the registered manager. The registered manager stated that should staff have any issues or concerns about her performance, then staff are aware that they can contact the provider directly. A separate Human Resources department was available within the provider (franchisee), should staff require support and guidance. The leadership team has carried out consistent and regular supervisions with staff to ensure that their views and feedback were heard. Records of three recent staff meetings were viewed where issues and work management arrangements were discussed.

Workforce equality, diversity and inclusion

Score: 3

Equality and Diversity training was in place for all staff to complete as part of their core training and completion compliance was high. Ethnicity, religion and sexual orientation were captured within people's care plans. Equality and Diversity Monitoring forms completed by staff as part of their induction included information on their religion, sexual orientation, ethnicity, disability. The equality and diversity policy had procedures and guidelines to follow, to ensure that adjustments and considerations could be made if needed. A separate Human Resources department was available within the provider (franchisee), should staff require support and guidance. Staff had access to a facility on the Atlas system they used to support staff wellbeing and this support was available at all times. The providers Lone Working policy also provided appropriate resources and processes to support the health, safety and welfare of any lone worker within the agency. The registered manager had signed up to the VISA approved overseas recruitment scheme with the Home Office. They also recognised the cultural and practical difficulties that overseas workers may have adjusting to life and work in the UK and had organised videos for those staff that demonstrated what it's like to live and work in the UK, for example costs of things, lifestyle etc.

The registered manager spoke confidently about the systems in place to ensure equality in the workforce of the service. Staff confirmed that the felt they were treated equally within the service.

Governance, management and sustainability

Score: 3

The Registered Manager understood their regulatory responsibilities. Review of Safeguarding statutory notifications were completed prior to on site assessment. Appropriate submissions were made to relevant local authorities. Quality assurance systems were in place to maintain oversight of peoples support and improve care delivery. Shadowing records viewed by inspector assess new staff’s performance in areas such as call time promptness, appropriately dressed, introductions to people, having valid ID on display, accessing care plans and undertaking notes, IPC procedures being followed, carrying out medicines administration safely, attitude and behaviour, and recording. The registered manager carried out regular Quality Assurance Reviews with people they supported and evidence of these were reviewed by the inspector. Good responses were viewed. Separate client service reviews were also completed when people's care package needed to be reviewed or updated due to a change in need. The registered manager had support from the provider who also had experience in care delivery and management. The registered manager confirmed that they often networked remotely with other managers based in the north of England. Management ensured that they, and care staff, understood their responsibilities relating to people's information, records and confidentiality. As part of their induction and training, all staff had completed a Handling Information course. Each person had a 'Data Protection Consent Form' where people's consent was sought on how information is used or shared. Emergency contingency plans were in place. In the event that facilities and systems become unavailable at the site office, all care information is stored electronically and could be accessed remotely to allow continuity.

The registered manager confirmed that the support from the provider was very good. The registered manager stated, "She's very good and on the end of the phone or email. We have regular meetings. She does audits usually yearly and does a lot remotely. I get results from this." Staff confirmed that the registered manager ensured that checks and competencies were completed within their role and that spot checks on the quality of care they provided were undertaken regularly.

Partnerships and communities

Score: 3

The registered manager confirmed that they communicated with the local authority if staff identified that needs had changed, and that care packages needed to be adjusted to reflect this. The registered manager said, "We have good working relationships, no issues." Staff spoke about occasions when they worked with other health and care colleagues in relation to the people they supported. One care worker said, "Sometimes they come when you are with the client. When they come, we give them information they want."

Some people we spoke to stated that staff would often support them to arrange healthcare appointments on their behalf.

Feedback from professionals and partners was positive on the engagement and professionalism of care staff and management. One Mental Health professional stated, "Support Solutions has demonstrated a commitment to transparency by promptly informing relevant stakeholders of any changes or challenges and seeking assistance when needed. This open communication has fostered a sense of trust and reassurance among all parties involved." Another said, "I appreciate Support Solutions' efforts to ensure consistency in support provision, especially through the allocation of specific workers who have proven to be effective in their roles. By prioritising continuity of care, they ensure that customers receive consistent and reliable support, which is essential for promoting stability and well-being. In summary, my experiences working with Support Solutions have been positive, and I believe they use best practices in care provision." As part of the assessment, we contacted the Local Authority in West Sussex for feedback. They confirmed that they had undertaken an Action Plan review at the service in 2023. A summary of the visit was seen by the inspector which confirmed that no issues had been raised by the review and the local authority contracts team confirmed that they did not have any concerns about quality.

The registered manager had utilised the support provided by professionals outside of the service. Appropriate referrals for specialist and health support had been made where relevant and needed. Any information was incorporated into people's care plans and support. There was effective engagement with specialist support such as District Nurses, local surgeries and GP's as well as Occupational Therapists.

Learning, improvement and innovation

Score: 3

The registered manager demonstrated they were open and proactive in learning and improvement. Issues that had been raised at the previous inspection had been acknowledged and addressed at this assessment. During the assessment, the inspector observed the registered manager and care coordinator discuss and address a technical issue with the call scheduling system. This had implications to how staff registered their time and tasks using the electronic app when they supported people in their homes. The registered manager and care coordinator contacted the systems designer to highlight this in an effort to resolve the issue. The registered manager had led the service for three years, since the beginning of the franchise. The service had been developed during the Covid pandemic which had provided challenges for the registered manager. Outside of the Care certificate training and mandatory refresher courses, specialist training was available for staff if a specific need warranted it. The registered manager stated that, through the Atlas system, they had access to all training courses and could provide training in areas such as diabetes or percutaneous endoscopic gastrostomy (PEG) training if required. The registered manager stated that they would seek face to face training from nurses in specific areas then cascade this knowledge down to staff.

The registered manager still sought to promote the development of staff with training. Accredited training qualifications had been offered to care staff although no one was currently undertaking them. The registered manager confirmed that, "I keep in touch with training for appropriate qualifications." The registered manager was proud at how they had sustained the service, despite starting during the recent Covid pandemic. The registered manager said, "My key achievement was setting up during lockdown, that was a challenge. The business ran from day one with an office. I focussed on the set up. I couldn’t go live until I had training in situ." Staff spoke positively about their role and the opportunities to develop. One staff member said, "You can easily learn new things from (the registered manager)." One staff member said, "I'm learning new things, helping clients. I want to." Another staff member said of the manager, "With me, she helped me personally.