Options Kernow

Options Kernow provides personal care to people living in their own homes in the community. It is a supported living service which aims to support people to 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. At the time of our inspection the service was providing support to 12 people with a learning disability living in Cornwall. Each person was supported by a team of staff for up to 24 hours per day.

People felt safe and well cared for by staff who’s company they enjoyed. People told us, “I am happy living here”, “[The staff] are nice to me” and “The staff are very good. I can have a laugh with them.” People’s relatives were also complimentary of the support the service provided and commented, “[My relative] is safe, [they] are very well looked after”, “The staff are wonderful, conscientious and caring” and “[My relative] likes them.”

All staff had completed safeguarding training and understood their role in ensuring people were protected from harm, all forms of abuse and discrimination. Staff were confident any concerns they reported to their managers would be addressed.

Each person was supported by a dedicated team of staff who they knew well. We found that the service employed sufficient staff to meet people’s needs and records showed planned levels of support had been achieved. There were appropriate systems in place to ensure people needs were met during unexpected periods of staff absence and staff told us “If someone phones in sick someone else comes in within a couple of hours.” The service only agreed to provided additional packages of care where suitable staff were available.

Staff were well trained and knew how to meet people’s support needs. All new staff completed comprehensive induction training which included the care certificate. All training was updated and staff told us, “The training is very good” and “They give you plenty of training.”

Care plans provided staff with sufficient guidance to enable them to meet people’s support needs. These documents were designed to help staff to provide consistent support. Care plans included details of the level of support people normally required with specific tasks and activities. Information about people’s life history hobbies and interests was included along with background information on the person needs to enable staff to provide personalised support. People and their relative’s had been involved in the development and review of care plans. We were told, “I made my own guidelines up, They do what I want them to do” and “I am involved in the care plan reviews.” Staff said people care plans were accurate and up to date and commented, “The care plans are very good” and “The care plans are very informative they are the first point of call. They are kept up to date.”

Risk assessments had been completed and clearly identified the actions staff must take to ensure people’s safety. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. Where people were at risk of becoming anxious or confused staff were provided with details of events and incidents likely to cause anxiety and guidance on how to support people to manage these issues. All staff had completed training in positive behavioural management techniques and staff told us, “We are trained in positive behaviour management techniques but we very rarely use it. Only when necessary to keep people safe. I think we have only had to use it twice in the last two years.” Relative were confident these techniques were used appropriately and told us, “Very rarely do they have to help [my relative] away from situations.”

All accident and incidents that occurred were documented and reported to managers for further investigation. Records showed all incidents had been appropriately investigated. This included the identification of any changes or improvements that could further ensure people’s safety and prevent similar incident from reoccurring. Staff told us, “They are very good at reflective practice. We have a full de brief in response to any incidents to identify anything that could have been done better.”

Staff and managers understood the requirements of the Mental Capacity Act 2005 (MCA). Where people lacked capacity in relation to specific decisions these had been consistently made in the person’s best interest with appropriate involvement from relatives and health professionals. The service had recognised some people’s care plans were potentially restrictive and was working with Cornwall Council to have these plans authorised by the Court of Protection.

The service had robust recruitment practices, which meant it only employed staff who were suitable to work with vulnerable people.

The staff team were well motivated and took pleasure in supporting people to live as independently as possible. There comments included, “I am very proud to work here”, “It is one of the best places I have worked. They really do try to live up to their aims. I would rate it 10 out of 10” and “I think this is one of the top places I have worked. It really is supported living.”

Staff were well supported by the service’s managers and records showed all staff had received regular supervision and annual appraisals. Staff told us, “I get supervision quite regularly”, “The managers are very good. I like the system here. We see the deputy manager pretty much every week and she does hands on observations” and “The managers are absolutely brilliant. They are very supportive.”

There were effective quality assurance systems in place designed to drive improvements in the service’s performance. Managers completed monthly audits of all aspects of care and the provider's operations manager had completed an assessment of the service’s performance in relation to the Care Quality Commission’s five key questions. Where any issues had been identified action plans had been developed to address and resolve these.

The service had system in place for the management and investigation of complaints and records showed all complaints received had been appropriately resolved. Relative told us they thought they would not be subject to any form of discrimination if they raised complains about peoples care and told us any issues were, “Resolved efficiently and very quickly by senior management.”

Hillcrest Kernow is a domiciliary care agency that provides personal care and support to people with a learning disability or a mental health condition in their own homes. At the time of our inspection the service was providing a 24 hour supported living service and personal care to nine people. A supported living service is one where people live in their own home and receive care and support to enable people to live independently. People have tenancy agreements with a landlord and receive their care and support from a domiciliary care agency. As the housing and care arrangements are separate, people can choose to change their care provider and remain living in the same house.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

Most people using the service had limited verbal communication and were un able to tell us their views about the care and support they received. However, we observed people were relaxed and comfortable with staff, and they received care and support in a way that kept them safe. People had a good relationship with staff and were comfortable with the staff that supported them. Relatives told us, “Staff are wonderful, I can’t fault them” and “[Person’s name] is very happy, they are always laughing.”

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People were supported by dedicated staff teams who were employed to work specifically with each person using the service.

Staff supported people to maintain a healthy lifestyle where this was part of their support plan. People were supported by staff with their food shopping and with the preparation and cooking of their meals.

People were supported to access the local community and take part in activities and outings that they enjoyed and wanted to do. Some people liked to have planned activities each day and for other people staff responded to their needs and wishes on a daily basis. Records showed that people went out most days for walks, shopping, day centres and visiting local attractions.

The management and staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

There was a positive and open culture in the service, the management team provided strong leadership and led by example. Staff were positive about the how the service was run. Staff told us, “You can pop into the office at any time”, “The communication is good within the management team” and “We [staff] are all well looked after.” A relative told us, “I have confidence in how the service is managed.”

Relatives said they knew how to make a formal complaint if they needed to but felt that issues would be resolved informally as the management and staff were very approachable. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.