Link-Ability

Updated 28 April 2018

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.

This inspection site visit took place on 22 March and 05 April 2018 and was announced.

We gave the service 24 hours’ notice of the inspection visit because it is domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

We visited the office location on 22 March 2018 to see the registered manager and office staff; and to review care records and policies and procedures and visited people’s homes on 05 April 2018.

The inspection team consisted of one adult social care inspector who is the lead inspector for the service.

Before our inspection visit we reviewed the information we held on the service. This included notifications we had received from the provider about incidents that affect the health, safety and welfare of people who used the service. We also reviewed the Provider Information Return (PIR) we received prior to our inspection. 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. This provided us with information and numerical data about the operation of the service.

We visited two properties with people’s permission to observe how people were supported in their own homes. We were unable to speak to some people due to their communications needs. We observed their interactions with staff. We met with six people who used the service, met one relative and spoke to one relative via the telephone. We received email feedback from six relatives and spoke to three care staff face to face. In addition we emailed all staff and received feedback from 17 staff. We spoke with the director, two trustees, assistant director, administration officer, operations manager and the registered manager.

We looked at the care records of five people who used the service, training and three recruitment records of staff members and records relating to the management of the service. We also contacted the safeguarding department at the local authority, other health and social care professionals and Healthwatch to ask them about their opinion of the service.

Updated 28 April 2018

The inspection visit took place on 22 March and 05 April 2018 and was announced.

Link-Ability is registered to provide personal care and support for people living with a learning disability or autistic spectrum disorder. Support is provided in people's own homes and can range from 24 hour care to an agreed number of hours on a weekly basis. This service provides care and support to people living in 15 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the visit there were 27 people who used the service.

At the last inspection in April 2015 the service was rated 'Good' with outstanding in responsive and was meeting the regulatory requirements relevant at that time. At this inspection in March and April 2018 we found the evidence continued to support the rating of good and the service had successfully retained an outstanding rating in responsive. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We received extremely positive feedback from relatives regarding the responsiveness of the staff their attitude and exceptional commitment to people they supported. 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.

Care plans demonstrated a holistic, excellent and exceptionally person centred approach aimed at maximising people's independence and choice. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care.

There was an exceptional drive to maximise people’s independence and significant efforts to promote social inclusion. This was supported by a highly motivated staff team that took a positive risk taking and person centred approach to their role. Feedback and comments from people was extremely positive.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service.

Staff skills, knowledge, training and support demonstrated a commitment to providing outstanding care which was embedded into the practices of the staff and the management team. The service put people's views at the forefront of the service and designed the service around their needs.

Risk assessments had been developed to minimise the potential risk of harm to people who used the service. These had been kept under review and were relevant to the care and support people required.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. However, improvements were required to the medicines management practices.

We found people had been assisted to have access to healthcare professionals and their healthcare needs were met.

We received mixed feedback from people and care staff regarding staffing levels in the service. However, we saw actions had been taken to rectify the concerns and staff recruitment was ongoing.

People who used the service and their relatives, knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager and the nominated individual used a variety of methods to assess and monitor the quality of service provided to people. These included regular internal audits of the service, staff and people’s forums to seek the views of people about the quality of care being provided.