Archived: Scope. Community Activities Cornwall

Updated 4 October 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 announced inspection took place on 12 September 2016. The inspection was carried out by one adult social care inspector. We told the service 48 hours before that we would be coming. This was in accordance with the Care Quality Commission current procedures for inspecting domiciliary care services.

Before the inspection we reviewed the information we held about the service. This included past reports and notifications. A notification is information about important events which the service is required to send us by law. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Prior to the inspection we spoke with one health and social care professional. During the inspection visit we went to the service’s office and spoke with both registered managers’ for the service, two regional team leaders and a member of support staff. We looked at three records relating to the care of individuals, staff records and records relating to the running of the service.

Following the inspection we met with a member of support staff and a person who used the service. We received feedback from one external adult social care professional who was familiar with the service. We also received feedback from six support staff who worked for the service and two relatives of people who used the service.

Updated 4 October 2016

We carried out this inspection 12 September 2016 and it was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services. This is the first time the service has been inspected under the current registration.

Scope Community Activities Cornwall Ltd is a domiciliary care agency that provides personal care and support to people with a physical and/or a learning disability in their own homes. At the time of our inspection the service was providing a service to 22 people, 18 of those were receiving support with their personal care needs.

The Care Quality Commission has responsibility for regulating personal care and this was the area of the service we looked at. Some of these people were receiving a 24 hour supported living service, while others received support from their family home to take part in activities in the community. A supported living service is one where people live in their own home and receive care and support to enable them to live independently. The contractual arrangements for tenancy agreements and personal care are separate so people can choose to change their care provider and remain living in the same house.

At the time of our inspection 22 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. The service employed 22 staff including management.

There were two registered managers 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.

People and their relatives told us they felt safe using the service, commenting, "I feel safe and am very comfortable with the staff", "I trust the staff and work alongside them to support my [relative].” and "Excellent service, can't fault it." People told us staff were kind, caring and compassionate; whilst being respectful of their privacy and dignity. Comments from people and their relatives included, "Staff are lovely and very helpful", "[Persons' name] is very happy with all the staff" and "Great team. No complaints whatsoever."

The service had faced difficulties recruiting enough staff. In order to meet this challenge, management had put together a recruitment action plan for 2016/17 aimed at attracting and retaining appropriate staff to the organisation. Management said they had employed agency staff to cover any potential gaps in staffing. People and relatives told us that in the main, the service managed staffing cover. One person commented, “The only negative comment is having enough staff to cover absences and sickness.”

The service had a contingency plan in place to manage any emergencies. Risks to people in the event of an emergency, had been assessed and rated, in order to identify who would be at the highest risk. There was 24 hour telephone contact available to people to be able to contact staff in an emergency. This demonstrated the provider had prioritised people's care provision during such an event. People were protected as robust processes were in place to manage emergencies.

People received care, as much as possible, from the same care worker or team of care workers. Rotas were planned in such a way as to minimise changes of staff. People told us they had regular staff and the times of their visits were agreed with them. Everyone told us the service was reliable, visits were never missed and they were kept informed of any changes to the time of their visits. People said, "We are fortunate that when Scope staff come, they are here for a few hours and if there has been any need to change times for any reason we are always given plenty of notice.”

Staff were recruited safely, which helped ensure they were suitable to work with vulnerable people. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

Staff received appropriate training and supervision. New staff received an induction, which incorporated the care certificate. All staff received an annual appraisal of their work.

Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed. Staff spoke passionately about the people they supported and were clearly motivated to provide an individualised service in line with people's needs and goals. Comments from staff included, "I can’t speak highly enough of Scope. It is a great organisation to work for” and “I think they provide a high standard of care which comes down to the person specific training staff are given before they’re left to get on with the job.”

People told us they were involved in decisions about their care and were aware of their care plans. Care plans provided staff with clear direction and guidance about how to meet people's individual needs and goals. These were reviewed regularly to evaluate the progress people were making against their overall goals.

The service worked successfully with healthcare services to ensure people's health care needs were met and had supported people to access services from a variety of healthcare professionals including GPs, occupational therapists and district nurses to provide additional support when required. Care records demonstrated staff shared information effectively with professionals and involved them appropriately. One healthcare professional told us, "They are good about reporting any concerns and asking for advice."

Management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

There was a positive culture in the service, the management teams provided strong leadership and led by example. Staff described the service as a ‘strong flexible team that pulls together at all times to support customers in some great activities’. Both registered managers had clear visions and values about how they wished their service to be provided and these values were shared with their staff team.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families told us the management teams were approachable and they were included in decisions about the running of the service. People had details of how to raise a complaint if they needed to but felt that issues would usually be resolved informally. Comments from people included, "I would recommend Scope to anyone" and "I would say this Scope service is well managed."