Archived: PSS Seel Street

Not everyone using PSS Seel Street receives regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Shared Lives is a form of support where vulnerable adults and young people over 16 years old live at home with a specially recruited and trained carer. It provides flexible day care, short breaks, intermediate care or long term placements in a carer’s home. At the time of the inspection, the service provided the regulated activity to 38 people.

The Supported Living service provides care and support services to enable people who need additional help to live independently in their own home. This service provides care and support to people living in five ‘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. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the inspection, the service provided the regulated activity to nine people.

Community Support provides support for people with learning, physical and mental health difficulties to live independently in the local community. At the time of the inspection, the service provided the regulated activity to three people.

Both the Shared Lives and Community Support scheme had their own registered manager. The Supported Living scheme had a manager in post who was not yet registered with the CQC. 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.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the overall rating of Good and 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.

Safe recruitment procedures were in place to ensure that staff and Shared Lives carers appointed were suitable to work with vulnerable people. There were appropriate numbers of staff deployed to meet people’s needs and to ensure people received consistent and timely support. Staff had received training in safeguarding and an organisational policy and flowchart procedure was in place to guide them. Carers understood how to recognise abuse and how to report concerns or allegations.

Medication was safely managed and administered by staff who had received the relevant training. Clear guidance was in place for those that required ‘PRN’ (as required medication). The registered provider had strengthened their systems and processes around medication recording following ‘themed reviews’ and lessons learned as a result of safeguarding enquiries. Regular medication audits and staff observation records were completed to ensure safe administration.

Risks to people’s health, safety and welfare were assessed and detailed information was available to guide staff to support people to stay safe, whilst promoting their independence and autonomy. Accidents and incidents were well documented and analysed for future learning and prevention. Arrangements were in place to ensure people lived in a safe environment and regular health and safety checks were completed in the supported living and shared lives settings.

Support plans were tailored to the individual and reflected each person’s needs and preferences and provided detailed guidance how they liked their routine to be followed. The registered provider had developed innovative means of enabling people’s support requirements to be documented in video format. This creative technology was used as a tool for people to tell their own story in their own words.

People, relatives and Shared Lives carers spoke positively about the service and the staff team who supported them. People described the staff as ‘brilliant’. People felt involved in making decisions about their care. One person told us, “I'm asked where I want to go and what I want to do. Staff talk to me; I'm not ignored or left out.”

Staff were assisted in their role through induction, training, supervisions and an annual appraisal. Staff and shared lives carers told us they felt well supported and sufficiently trained in order to carry out their roles effectively. Some staff had received tailored training to meet people’s specialist needs such as epilepsy and specific equipment training.

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. The service operated within the principles of the Mental Capacity Act 2005 (MCA) and processes were in place to assess people’s capacity.

Staff worked with external professionals to support and maintain people's health and well-being. People were supported to access health appointments and there was evidence of health action plans and health passports within files.

People had access to a complaints procedure and complaints were dealt with appropriately and in accordance with the timescales set out in the registered provider’s policy. People felt confident that any concerns would be listened to and acted upon.

Staff understood the vision of the service and maintained a focus throughout their practice on the delivery of support in a person centred way. People told us that staff promoted their independence and encouraged their daily living skills.

The culture of the organisation was one of continuous improvement and development and the registered provider demonstrated their commitment to this through proposed new initiatives such as the implementation of the ‘outcome star’ tool to measure progress against people’s individual goals.

Roles and responsibilities were clearly defined with a designated manager for each service and a Head of Service to provide oversight. There were a number of different systems in place to assess and monitor the quality of the service, ensuring that people were receiving safe, compassionate and effective care. Audit systems were robust and consisted of a variety of self-assessment tools to examine performance in key areas. This included quality assurance checks in respect of areas such as care plans, health and safety and medication.

The vast majority of feedback we received was positive and people were complimentary about the running and organisation of the service. One person told us, “It’s the best it’s ever been.”

The service worked with wider partners to ensure people received safe, effective and compassionate care. The registered manager told us how they engaged with local partners from community policing to deliver training to people on safety in the local community.

The registered provider had notified the CQC of events and incidents that occurred at the service in accordance with our statutory requirements.

Staff provided a good verbal explanation of how to support people with their decision making and the steps they had taken as one person's capacity diminished. People who used the service told us they had helped with their care plans and agreed to the contents of them.

We found that some people who used St Helen's and Knowsley Community Support did not have a care plan for all their assessed needs and that some of their care plans had not been regularly reviewed and updated.

Staff told us they had completed a detailed induction programme and regular training relevant to the work they carry out. However we found that staff in St Helen's and Knowsley Community Support had not received an appropriate level of supervision and appraisal.

We found that the systems in place for assessing and monitoring the quality of the service were ineffective. We were told that a new system had been developed and was due be implemented in the near future.

People told us they knew how to complain and that they would do so if they needed to. People said they were confident that their complaint would be dealt with in the right way.

We found that records were not properly maintained and stored in St Helen's and Knowsley Community Support.