Egalite Care

Egalité Care Limited provides care and support to people living in their own home, supported living accommodation or their family home. People using the service include people living with a learning disability and/or physical disabilities. At the time of our inspection, there were 60 people being supported by the service.

There were seven supported living homes across coastal West Sussex providing support for 33 people. There were no external signs, intercom, cameras, industrial bins or anything else were not in use, to indicate it was a supported living home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. This meant people were not identified as receiving care and their privacy respected.

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 exceptionally well planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Following the last inspection, the registered manager, management team and staff had worked continuously to provide people with outstanding care and support. They understood that maintaining this high level of care required dedication and commitment, and we saw this across the whole staff team. Staff were focussed on continually developing areas of the service with person centred support at the centre of these improvements. Staff were dedicated to supporting people to improve their independence, access to activities that met their interests and being active in the local community. The management team continued to develop their extensive knowledge of supporting people living with a learning disability and upskilling their staff team. This meant that people received high-quality care from staff who truly understood their needs.

The management and leadership of the service were exceptional. The registered manager and management team had an excellent understanding of the provision of care and support for people living with a learning disability. They had actively sought education opportunities for themselves and their staff to build on their detailed knowledge following the last inspection. This meant people had access to the highest quality care from managers and staff that had an exceptional knowledge of their needs. A health and social care professional told us, “I would use Egalité as an example of what small providers can deliver in terms of high-quality support. Egalité has managers that are confident, proactive and understand learning disability.”

The registered manager was committed to continuous learning and fostered a supportive and enabling culture for both people and staff. People, their relatives and staff were highly complimentary of the management of the service. A relative told us, “We can’t fault them at all, they manage everything well and my loved one is happy and content.”

People received a truly person-centred service which promoted excellent outcomes for them which included supporting their independence and to have control over their lives. Following the last inspection, the management team focussed on further developing people’s independence to enhance their quality of life. This had resulted in people having new and exciting experiences, reducing the level of support they needed due to staff developing people’s skill sets and people moving on from the service with a new level of independence and lease of life. The management and staff team continued to foster a caring and compassionate culture which put people at the centre of their care. People were supported to follow their interests and staff supported them to overcome any barriers to make the most of new opportunities. Staff really cared for people they supported and were invested in maintaining and promoting their wellbeing.

Staff had an in-depth knowledge of the people they supported and worked with them daily to improve their quality of life. Activities were led by people’s choices and were reflective of their social, cultural and wellbeing needs. Staff really focussed on people’s interests to enable them to have new experiences. People were supported to be active in their local communities and develop new skills to broaden their horizons.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s nutritional and healthcare needs were met in a timely way. Staff received a range of training opportunities that were specifically designed to enable them to effectively support people using the service.

People were safe. One person told us, “I do feel safe, they are very good. I would tell the carers if I felt unsafe.” Risks to people were identified, assessed and

managed safely with an enabling and empowering focus so no one was restricted. Staff supported people to take positive risks and were flexible in their approach. There were enough staff to meet people’s needs safely and recruitment processes were robust with people included so they had a say about who might be employed to support them. Medicines were managed and administered safely, by trained and competent staff who supported people to have as much control as possible .

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

Why we inspected

This was a planned inspection based on the previous rating.

Rating at the last inspection

The last rating for this service was outstanding (published 03 August 2016).

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.

Egalité Care Limited provides care and support to people living in their own home, supported living accommodation or their family home. People using the service include people with learning disabilities and/or physical disabilities. At the time of our inspection, approximately 65 people were supported by the service.

A registered manager was 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 were supported by exceptionally kind and caring staff who went beyond the responsibilities of their job role to ensure that people led meaningful lives. Staff took time to engage with people, providing reassurance and support in a way that built up people’s confidence and self-esteem to pursue interests and hobbies that were important to them. Friendships were inclusive, supportive and empowering. The provider was in the process of re-evaluating the care plans and formatting the information in a more accessible way, to enable people to have a greater understanding and involvement in their care. Staff and people treated each other with dignity and respect and people had the privacy they needed.

There was a strong emphasis on person-centred and inclusive care that empowered people to be as independent as possible and achieve their full potential. All staff adhered to the principles set out in the provider’s Statement of Purpose and demonstrated these in practice. People’s feedback was gathered through their responses to a series of multi-choice questions. Staff views were also important to the provider. The management team had acted on the results of the surveys and put in place additional employee benefits for staff. Staff told us they felt valued and were part of the ‘Egalité family’. They were treated as equals and staff, including management, worked alongside each other as a team.

Care was of high quality and commendations and compliments from professionals and relatives were recorded and demonstrated this. The service had fostered excellent relationships with people, their relatives and worked in partnership with other agencies in the community. People spoke highly about the staff and the care provided by Egalité Care. A robust system of audits was in place to measure and monitor the service overall to ensure a high quality of care was delivered continuously. Ways to improve an already exceptional service were strived for.

Staff had received training in all essential areas as part of their induction and this was refreshed as needed. New staff followed the Care Certificate, a universally recognised qualification and checks were made on their suitability to work in care before they commenced employment. Additional training was organised for staff based on people’s particular care needs. The management took great care to match staff with people they were supporting which provided a firm foundation on which positive, caring, friendly relationships could be developed. Staff were supported by management to pursue additional qualifications if they wished. Supervision and staff meetings took place and staff felt supported by management. They felt their views were listened to and they were encouraged to contribute their ideas on how the service could develop and improve.

People were protected from potential abuse and harm by sufficient numbers of trained staff who helped to keep them safe. Risks were identified and assessed and managed appropriately. Medicines were managed safely and where errors had occurred, these were investigated and acted upon promptly. Staff competency to administer medicines was undertaken every six months and their training renewed annually.

People were involved and encouraged in all aspects of their care. Staff had a good understanding of the legislation under the Mental Capacity Act 2005 and put this into practice. People were encouraged to maintain a healthy lifestyle in their diets and had access to a range of healthcare professionals and services. Care was person-centred and responsive to people’s needs; they were encouraged to be as independent as possible. Complaints were managed appropriately.

We visited three people in their homes, including supported living services, with care staff and the manager. We visited five people who were attending a local centre that provided activities, work and training opportunities for people with a learning disability. We spoke with the Riding Therapy Manager from this centre. We spoke with three people's relatives and a person's carer. We spoke with the Senior Physiotherapist, West Sussex Learning Disability Health Team and the Learning Disability Lead, NHS Continuing Healthcare Coastal West Sussex. We spoke with the registered care manager, the operations manager, and six care and support workers and we reviewed six people's care plans. We reviewed records related to the management of the home and people's medication records.

Below is a summary of what we found. The summary describes what people using the service, their relatives, other professionals and staff told us, what we observed and the records we looked at.

Is the service safe?

People's relatives told us their relatives were cared for safely. One relative of a person who had physical and learning disabilities and was unable to communicate their experience said, "I don't have any misgivings or fear for my relative's care. Initially I was apprehensive about their move into supported living, but we are very happy with the results." Another relative of a person with a learning disability said, "Staff have a very good approach for my relative's needs, I feel very comfortable when my relative is in their company and I can relax because they are in good hands."

Systems were in place to ensure people's medicines were safely and appropriately managed. A person's carer said, "All staff that support the person are assessed with their medicines, they are well trained and I have no qualms at all."

When people did not have the mental capacity to make some decisions the provider followed the appropriate procedures under the Mental Capacity Act (2005).

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from our observations and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us, "They ask me what I want and listen and understand." A relative said, "The care for our relative is excellent, I couldn't have asked for anything better."

People's care plans were person centred and reflected their individual needs and preferences. The provider worked in co-operation with others to ensure people experienced safe and effective care and treatment. Other professionals told us the provider communicated well and worked proactively to ensure people's needs were met by other services in a joined up way.

Staff had a good understanding of people's needs and risks. Records showed people were supported by staff who were trained and supported to meet people's individual needs safely.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff treated people with dignity and respect and showed patience and encouragement when supporting people. People we spoke with confirmed that staff were kind. A person said, "My support worker takes me out for one to one time they are really nice." A relative said, "I feel they really care for my relative."

Is the service responsive?

Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People were supported to participate in a range of activities within the community and people were supported to maintain relationships with their friends and relatives. One relative said, "The really nice thing is that staff bring my relative over to spend time with us every week and get them out and about. They really enjoy this and it works really well." We saw evidence people were supported by a range of providers to meet their needs.

Is the service well led?

Quality assurance processes were in place. This helped to ensure the provider could identify where improvements were required to deliver a good quality service. Records showed that people and their relatives were asked for their feedback on the service and their comments were acted on. One relative said, "The manager has a genuine desire to help people, a real passion for it, it's not just a business." Staff told us they were well supported by their managers. One staff member said, "I have an allocated supervisor and I can go to any of the managers. They all make sure everyone is supported." Staff received an induction that included a session with the registered manager to learn about the key principles of 'valuing people' that underpin the ethos of the service.