Background to this inspection
Updated
14 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was conducted by one inspector.
Service and service type
This service provides personal care to people living in their own houses and flats. In addition, they provide care and support to people living in five ‘supported living’ settings, so that they can live 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.
The service did not have a manager as the previous registered manager had left the service. There was a deputy manager and the provider’s area manager who supported this inspection. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The area manager told us that the provider was in the process of trying to recruit a new manager for the service. In the meantime, the deputy manager was supporting the management of the service with the guidance of the area manager.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or deputy manager would be in the office to support the inspection.
What we did before the inspection
Before the inspection we reviewed the information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
Inspection activity started on 21 November 2019 and ended on 9 December 2019. We visited the office location on 21 November 2019.
During the inspection-
We interacted with, and had limited conversations with, three people who used the service. However, some people using the service were not able to verbally express their views. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the deputy manager, the provider’s area manager and one care staff member.
We reviewed a range of records. This included six people’s care records and medication records. We reviewed training records and a variety of records relating to the management of the service, including policies and procedures, audits, staff training records and staff rotas.
After the inspection
We looked at three staff recruitment records and reviewed three staff files in relation to supervision. We spoke with four relatives about their experience of the care provided. We spoke to three external professionals involved with the service and five members of care staff.
Updated
14 January 2020
About the service
Options West Sussex is a domiciliary care agency providing care and support to people living in their own homes who have a range of needs, including people with a learning disability and Autism. CQC only inspects where people receive personal care. Not everyone who used the service received personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 22 people were receiving personal care.
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.
People’s experience of using this service and what we found
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. However, records had not always been made for decisions completed in people’s best interest. We recommended that the management team continue to review guidance on the Mental Capacity Act 2005.
People told us they were happy with the service they received and staff treated them with kindness and respect. Relatives gave us positive feedback about people’s safety and told us that staff did their job well. One relative said, “I trust them [staff], and know they will look after [Person’s name] and keep them safe.”
Staff had completed training in the safe administration of medicines and people received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording and disposing of prescribed medicines.
Systems were in place to monitor incidents, accidents and near misses. There were clear processes in place to monitor risks to people, which helped to ensure they received effective care to maintain their safety and wellbeing.
Staff received an induction into their role and had received appropriate training that equipped them to support people. They had regular refreshers of training to help ensure they continued to be sufficiently skilled and knowledgeable. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.
People's needs were assessed to ensure these could be met by the service. The management team and staff worked with other external professionals to ensure people received effective care.
People had detailed and accurate care plans in place, which were person centred. Staff supported people, showed an understanding of equality and diversity and people were treated with dignity, and their privacy was respected. People and their relatives where relevant, were involved in the planning and review of their care. People were supported to maintain their independence and encouraged to participate in activities of daily living.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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.
A complaints procedure was in place, which relatives and people confirmed they were aware of. People's concerns and complaints were listened to, addressed in a timely manner and resolved quickly.
Staff, people and relatives told us they had a good relationship with the management team and could seek support and assistance easily when needed. There were effective systems in place to monitor the safety and quality of the service.
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 26 May 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.