Barnardo's Disability Support and Inclusion (DSI) Service

Updated 13 December 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 checked 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 took place on 24 October 2018 and was announced.

We gave the service 48 hours' notice because the service is small and the registered manager can be out of the office supporting staff. We needed to be sure that they would be available to speak with us.

The inspection team consisted of one adult social care inspector and a specialist advisor with experience of children's support services.

Before the inspection, we checked for any notifications made to us by the provider and reviewed the information we held on our database about the service and provider. Notifications are sent to us by the provider to inform us of important events that happen within the service, such as safeguarding incidents.

There were 49 people receiving a service and of those 26 were receiving a regulated activity at the time of our inspection. Providers are required by law to register for each of the regulated activities they carry out. This provider was registered to carry out personal care.

During the inspection we spoke with two care staff, the deputy manager and the registered manager. We contacted six health professionals for their feedback about this service.

We reviewed care records for four people, recruitment and training records for two care staff, records of safeguarding incidents and complaints and compliments. We looked at records relating to the management of the service, including policy documents, satisfaction surveys and staff meetings.

Following the inspection we contacted three families to discuss the services they received and ask for their views about the staff, care provisions and management at this service.

Updated 13 December 2018

This inspection took place on 24 October and was unannounced. At the last inspection on 23 February 2016 we rated this service Good. At this inspection we found the evidence continued to support the 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.

Barnardo's Disability Support and Inclusion (DSI) Service is registered for the regulated activity 'personal care'. The remit of the service has changed slightly due to changes in service contract agreements with local authorities and the clinical commissioning group. At the time of this inspection Barnardo's DSI Service provided 'short break services' to the families of children or young people who have special needs because of a disability. 'Short break services' can include time spent with children or young people in their home or in the community on an activity, or taking part in a pastime.

Not everyone using Barnardo’s Disability Inclusion and Support Services receives a regulated activity; 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in place at the time of our inspection. 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.

Staff were aware of the different types of abuse, how to recognise them and how to report them to senior management or other external agencies.

Procedures were detailed around practices for medicines administration. Parents and carers told us these were always administered appropriately and on time.

The induction process was comprehensive and additional courses could be accessed by staff to continually develop their skills and knowledge. The management team encouraged partnership working such as specialist training with health professionals. Staff had built strong working relationships with partner agencies to achieve positive outcomes for people.

Recruitment processes were robust and included pre-employment checks to ensure people were suitable to work with children and young people.

Activities were varied and took into consideration people's likes, dislikes and suggestions. We saw positive feedback from people that received services and their parents and carers.

Care plans were personalised and included information about peoples likes, interests and preferences. The provider was in progress of improving collation of information around people's life histories.

Risk assessments were detailed and provided personalised information to enable staff to support people in line with best practice whilst considering people's preferences.

Parents and carers told us that staff practiced good standards of personal hygiene. All staff completed infection prevention and control training.

Reviews of care were completed regularly and parents and carers were encouraged to participate. Staff were keen to ensure children and young people had their views heard. The provider demonstrated positive outcomes for people and this was an area they were looking to record in more detail in the future.

Staff had a good understanding of equality and diversity and gave examples of how they supported people's diverse needs.

Regular staff and management meetings addressed current issues. Actions plans showed that staff views and opinions had been listed to and measures taken to improve the working environment.

The service was proactive in engaging with parents and carers through meetings, home visits and annual satisfaction surveys.

Feedback around communication and the leadership of the service was positive. Parents and carers praised staff for their continued support and described staff and management as 'amazing'.

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 registered manager had good oversight of the service and had introduced positive changes to drive improvements in the service.

Further information is in the detailed findings below.