Archived: Riverside Christian Centre

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Prospects for People with Learning Disabilities is a Christian faith led charity organisation specialising in providing care, support and independence for people with learning disabilities. They have seven registered locations across England and Wales. On 11th May 2016 they became part of the Livability group. Livability is a national Christian disability and community engagement charity.

The service is registered with the Care Quality Commission (CQC) for the provision of personal care in people’s own homes. Prospects provides a ‘supported living’ service. This is where people live in their own home and receive care and/or support in order to promote their independence. The support that people receive is often continuous and tailored to their individual needs. It aims to enable the person to be as autonomous and independent as possible. There is genuine separation between the care and the accommodation, the care they receive is regulated by CQC, but the accommodation is not.

At the time of the inspection the service supported 10 people, who had individual tenancy agreements, living in two shared occupancy houses in Exeter and Torquay. Personal care was provided to five of these people. People who used the service had varying degrees of difficulties and support needs, ranging from mild to severe learning and physical disabilities and autistic spectrum conditions. Some people had complex needs and required 24 hour support, whereas others were relatively independent and just needed assistance for a few hours each day. The service also provided other forms of social care support that are not included within CQC’s registration requirements for a supported living service. For example, in addition to personal care, the service also assisted people with their housekeeping, shopping, attending appointments and other independent living skills.

There was a registered manager 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’s rights were not always protected, because the service did not always act in line with current legislation and guidance where people lacked the mental capacity to consent to aspects of their care or treatment. Managers had not recognised that some people were potentially being deprived of their liberty, and that this required authorisation by the Court of Protection, however they acted immediately to address this.

The service was not always responsive because there was not always evidence to show the support provided was planned around the needs and wishes of the person, rather than the needs of the organisation. For example, a relative told us their family member was unable to go out for the day because the member of staff supporting them had to be back for the staff handover in the afternoon.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff had received a range of training and information including safeguarding adults and they were confident they knew how to recognise and report potential abuse.

People’s enabling plans were clear and contained clear guidance for staff to help them meet people’s support needs effectively and according to their wishes and preferences. Staff had a good understanding of people’s individual nutritional needs in line with their enabling plans. They followed recommendations from health professionals to ensure people’s nutritional needs were met safely.

Staff respected people’s privacy and dignity, and this was promoted by the organisation. Enabling plans contained clear guidance for staff to help them to promote people’s ability to make choices and maintain as much independence as they were able.

Systems were in place to ensure people received their prescribed medicines safely, where they needed assistance or prompting to take their medicines. Where necessary, people were also supported to access other health and social care professionals to maintain good health and well-being.

Staff were well supported. Managers were very visible and accessible to them and the people they supported. Staff received regular one-to-one supervision and attended monthly staff meetings. They were supported with their immediate training needs, as well as their continued professional development. They told us the current management team was “brilliant”. That there was an “open culture…a respect and understanding, and a diligence there for the people we support and management of staff”. Staff and relatives expressed concern that there had been a high turnover of managers at the service, and were sorry that the registered manager was temporary, pending the recruitment of a permanent manager.

The provider had a range of monitoring systems in place to check the service was running smoothly and to identify where improvements were needed. A comprehensive service improvement plan was underway. People and their relatives were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways. They were asked to complete annual survey forms seeking their views on all aspects of the service.

We asked relatives about their experiences of the support their family member had received by phoning them on 30 December 2013. Comments were positive about the care provided but did say that care plans were not always used as working documents and that information was often communicated verbally. We spoke with two staff who were delivering care at the time of our inspection. They were knowledgeable about people's needs and told us that they felt well supported in their roles. The agency were providing care for eight people who required personal care in two supported living schemes in Exeter and Torquay and employed around 18 care workers.

We looked at care records kept in the office and also in people's homes. We also looked at key documents including care plans, risk assessments, staff training, supervision and complaints/compliments files and policies and procedures.

We saw from observation and from records the support given by the agency met people's complex needs and their dignity was respected whilst staff promoted their independence. We heard examples of how people received personal care in a private and dignified manner.

Care and support was well assessed and planned, with people being involved with decisions of how their care should be delivered. Detailed plans were in place to minimise any identified risks and ensure that staff had the information to meet people's needs. Staff showed us how they cared for people in an individualised way and identified changes in people's needs in a timely way.

One person told us,' It is really great here, all good.' This was borne out in evidence from the care records which showed positive evidence of independence. We found that the care planning demonstrated a holistic approach to ensure that the service met the standards for safe, quality care and support. We found evidence of appropriate risk assessments. Relatives of people influenced decisions about the care and support.

We found that the key worker role served to promote the views of the person.

We observed positive relationships between people and staff used to encourage the autonomy of people.

Staff were supported to develop their skill and were supported through a system of supervision and appraisal.

Safeguarding procedures were in place and appropriate actions were put in place to address the concerns. There was evidence that learning from incidents took place and appropriate changes were implemented.