Archived: Sign Health London Outreach

SignHealth Outreach provides personal care and supports deaf people to lead independent lives. They support people across the whole of London. All of the outreach workers that support people are either deaf or fluent in British Sign Language (BSL). At the time of the inspection, the provider was supporting approximately 20 people ranging from a few hours a week to more intensive support very day.

There was a registered manager at 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 2008 and associated Regulations about how the service is run.

People told us that they felt safe in the company of care workers. They told us they would not hesitate to speak with the registered manager or staff if they were worried about anything. They told us they led independent lives and were able to take part in activities and pursue their own interests. Some people went to college, others went to the gym and attended deaf club.

People were supported in their daily living activities with the appropriate level of staff support. The people we spoke with lived in individual flats in a shared home. They all did their own shopping, prepared their own meals and took their own medicines. They said they were all confident in carrying out these tasks but staff were always there to help them if needed. Staff gave guidance and prompted people and made sure they had what they needed.

Staff communicated effectively with people using the service in British Sign Language (BSL). All the staff were BSL trained and the provider also made use of technology to enable more effective communication with deaf people and staff, using video calls via Skype to speak with them.

Care plans included risk assessments and support plans that were individual to people. Care records were written in plain English and the provider made use of pictures to help people understand them better. Care records were signed by people, indicating their agreement to their content.

The provider had thorough recruitment checks in place which helped to ensure care workers were suitable to work with people. This included taking references, identity and criminal background checks.

Caregivers completed an induction programme which included going through the role, an introduction to the organisation and completing some shadowing shifts with experienced care workers.

Although on-going training was provided, this was not tracked effectively so we could not be assured about the level of training that care workers received.

There was an open culture at the service. The registered manager took time speaking to people and staff and made himself available either visiting people in their homes or by video calls.

Although care records were reviewed regular and checks were carried out in people’s homes, there was a lack of formal quality assurance from a management perspective. Some of the quality assurance audits had not been carried out recently. Other audits such as feedback surveys were completed for the provider but the results were difficult to narrow down to the service we inspected.

All new staff, including bank staff, were required to attend an induction day which included an introduction to the service and shadowing experienced care workers. We saw evidence that new staff were supervised regularly during the probationary period which lasted six months. The manager told us "we assess their care skills and if they would work well with our clients".

We looked at a number of policies related to record keeping during our visit. This included the confidentiality policy which was in line with the Data Protection Act 1998, the Information Governance policy, and the Data Protection policy. These policies had all been reviewed in September 2013. The manager told us that all staff were expected to read the policies either during their induction or when they had been amended.

Copies of the care plan were kept in people's homes, these were produced in accessible easy read formats for people to relate to. We saw a sample of care plans, these were detailed and reviewed regularly.

Staff were aware of the different types of abuse and how to identify it and the escalation procedure for reporting abuse. Staff talked to us about their induction and training and spoke about how the senior staff supported their development needs. One staff member told us that 'I feel I can approach the manager at any time for any training needs'.