St Anne's Community Services - Leeds DCA 2

St Anne’s Community Services – Leeds DCA 2 is a supported living service providing personal care to people with a learning disability in their own homes. When we inspected the service there were 16 people receiving support. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered managers at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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

People were safe and happy in their homes and with the care and support they received. The provider took steps to protect people from risks, including the risk of abuse or avoidable harm. Medicines were managed safely. Enough staff were employed to support people and appropriate arrangements were in place to recruit staff safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to do the things they wanted to. Staff and the registered managers were enthusiastic and highly motivated to provide person-centred care based on people's choices and preferences.

Staff were trained and supported to deliver care according to people’s needs; and worked with other agencies to deliver consistent and effective care. People were supported to maintain their health and had a varied and balanced diet.

Support plans were person-centred and detailed. People told us staff were caring and treated them well. People had developed caring and kind relationships with staff and the registered managers. Staff and the management team worked to respect and promote people’s privacy, dignity and independence.

The service was well led. The provider and registered managers assessed and monitored the quality of care. There was a positive, person centred and caring culture in the service led by the registered managers. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 this service was good (published 25 March 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.

St Anne’s Community Services – Leeds DCA 2 is registered to provide personal care to people in their own homes. When we inspected the service there were 20 people receiving support in 7 properties. Each person held a tenancy with their landlord. The service is registered to support people who have a learning disability and people who live with autism.

The service had an administrative office in South Leeds.

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 and associated Regulations about how the service is run. The registered manager did not however, have overall management responsibility for all the supported living services.

At the last inspection in August and/ September 2015 we found the provider had breached one regulation associated with the Health and Social Care Act 2008 in relation to medicines. We told the provider they needed to take action and we received a report from them setting out the action they would take to meet the regulations. At this inspection we found improvements had been made. with regard to this breach.

People who used the service were comfortable and relaxed in the company of staff and with those they lived with. People were supported to avoid the risk of accidents or harm and they were helped to manage their medicines safely. Health care needs were met well, with prompt referrals made when necessary.

There were enough staff to provide people with the support they needed and background checks had been completed before new staff had been appointed to ensure safe recruitment practice. Staff were able to tell us how they could recognise abuse and knew how to report it appropriately.

Staff felt well supported by the provider. They received appropriate training and supervision which ensured they understood their roles and responsibilities. Managers had identified where refresher training was out of date and were working with the provider’s training department to address this.

The management team and staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had, in the main, made appropriate applications to the relevant authorities to ensure people's rights were protected.

People chose their own food and drink and were supported to maintain a balanced diet where this was required.

Care records contained detailed, person centred information to guide staff on the care and support required and contained information relating to what was important to the person. These were reviewed regularly and showed involvement of people who used the service or their relatives.

People were supported to pursue social interests relevant to their needs, wishes and interests and received the assistance they needed to maintain contact with family and friends.

Staff treated people with kindness, compassion and respect. Staff recognised people's right to privacy and promoted their dignity. Confidential information was kept private.

Regular quality checks had been completed to ensure people received the support they needed. However, some members of the management team had completed spot checks at people’s homes when they were not in. They did not have permission to do this. The area manager took immediate action to rectify this when we brought it to their attention. Senior managers had not been aware of this practice.

Due to the way the service had been set up the registered manager was being held to account for areas of work over which they had no day to day control. The area manager informed us of the plans in place to address this.