Archived: Outreach

Updated 9 May 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 8 March 2018 and was announced.

The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to allow enough time for the provider to arrange for us to visit people in their own homes on the day of the inspection.

The inspection team consisted of an inspector.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed other information we held about the service. We considered the information which had been shared with us by the local authority and other people, looked at any safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events the provider is required to tell us about by law. This is necessary so that, where needed, the Care Quality Commission (CQC) can take follow up action.

During the inspection, we visited one person in their home to talk with them and observe their care. We spoke with a relative of the person on the telephone. We spoke with two support workers, the deputy manager and the registered manager.

We reviewed care records for the one person receiving personal care support and ‘pathway tracked’ them to understand how their care was being delivered in line with this.

We reviewed staff training, supervision and recruitment records, medicines records, care plans, risk assessments, and accidents and incident records. We also reviewed complaints and compliments documents, quality audits, policies and procedures, staff rotas and other records related to the management of the service.

Updated 9 May 2018

We carried out a comprehensive inspection of Outreach on 8 March 2018.

Outreach is a domiciliary care agency. The service provides support to adults and younger adults with learning disabilities or autistic spectrum disorder. It provides personal care to people living in their own houses and flats in the community and to people in supported living arrangements.

Supported living is where people receive support 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.

Not everyone using Outreach received regulated activity; CQC only inspects the service being received by people being provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where the service does provide any wider social care, we also take this into account. At the time of the inspection the service was supporting one person with personal care.

Outreach 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.

The service had a registered manager in post. 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.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in December 2016.

There were systems and processes in place to keep people safe from abuse and avoidable harm. The person using the service told us, “I feel very safe”. People using the service had support to know what abuse, including discriminatory abuse, could look like and how to get help.

Staff had received safeguarding training and knew how to recognise and report abuse. The registered manager reviewed and investigated any safeguarding incidents or concerns and took action to keep people safe. People had risk assessments in place and any control measures needed to minimise risks were put in place in the least restrictive manner. Staff reported accident and incidents and the service took appropriate action to prevent future incidents from occurring.

There service had enough staff with the right skills and experience to meet people’s needs. Rotas were written so staff matched the needs of the people they supported. There were safe recruitment practices and all staff had a satisfactory Disclosure and Barring Service (DBS) check.

Staff had received training in infection control and food hygiene best practice and provided support for people to maintain a clean and hygienic environment and to store, prepare and handle food safely.

People’s physical, psychological and social needs had been assessed so staff knew the support they needed and how to help them achieve their preferred support outcomes. The person using the service and their relative told us they had been actively involved in this process. The provider promoted equal rights for people with learning disabilities and was committed to helping people overcome any form of discrimination to achieve the support outcomes they wanted.

The provider operated a number of other different services within its organisation to help people achieve good outcomes and have a good quality of life. Staff worked with these internal services to co-ordinate people’s support, so their needs could be effectively met. The person using the service told us they were encouraged to attend the evening social events at the provider’s drop in centre, which allowed them to meet friends independently. Staff told us of examples where Outreach clients had successfully been able to find jobs after receiving support to be referred to the provider’s employment service.

Staff had training in a range of subjects, including learning disabilities and autism to give them the right skills and knowledge to be able to meet people’s assessed needs. Staff could request additional training at any time if they felt they needed to improve their skills. Staff received an induction that met the Care Certificate standards and had on-going probation, supervision and appraisals to help them to be confident they were meeting people’s needs in the best way.

The person using the service told us they consented to all aspects of their care and were involved in regular reviews of their support. Staff received Mental Capacity Act (MCA) training and people were supported appropriately in line with the consent and decision-making requirements of this legislation. Staff regularly discussed people’s wellbeing and helped them to quickly access healthcare services if needed. The person using the service had effective support to understand and maintain a balanced diet and the service promoted the importance of healthy eating.

The person using the service told us staff were kind, listened to them and offered them emotional support if they needed it. They said, “I can talk to staff if I have had a bad day. If staff see that I am upset they encourage me to talk about what is wrong”. Staff knew and respected who people were as an individual and had built trusting and productive professional relationships with people using the service.

Staff involved people in making decisions about their care so they felt included and had control over their support. The person using the service was communicated with in a way that suited them best and was encouraged to be as independent as possible. People’s privacy, dignity and confidentiality was respected. People’s personal information was managed in line with the principles of the Data Protection Act.

The person using the service and their relative contributed to the planning of their care and support and this was regularly reviewed. Their care plan contained details about their personal preferences, strengths and levels of independence. Staff read these and talked to people and their families so they knew how to meet their needs in a personalised way.

The person using the service was encouraged and supported to develop and maintain relationships, follow their interests and take part in meaningful activities of their choice in the wider community. Information about care and support for people with a disability or sensory loss related communication need was available for people, as outlined in the principles of the Accessible Information Standards (AIS).

The person using the service told us they knew how to raise a complaint and felt confident to do so. There was a complaints policy in place complaints were reviewed by and responded to appropriately and used as a learning experience to improve the service.

There was a positive and inclusive team culture. The registered and deputy manager were capable and visible. Staff contributed to developing the service. Managers and the wider organisation recognised and rewarded individual and team achievements and staff felt valued and encouraged to carry out their roles to a high standard. The service took steps to help staff maintain good physical and mental well-being. An equality and diversity policy was in place and the service was committed to supporting the equal rights of staff with protected characteristics under the Equality Act 2010.

The provider had a clear vision of empowering people with a learning disability and strengthening their relationships with other people in their community. There were expected values in place for staff to follow to help realise this vision. The registered manager used regular supervisions and performance reviews to embed these values in staff practice. People’s views and experiences were gathered and acted on to shape and improve the service and its culture.

Quality assurance and governance systems were in place. Management used these systems to effectively monitor the quality and safety of the service and ensure actions and improvements were being completed on time. Service performance was measured against current compliance and best practice guidelines and regularly audited. This identified what was and wasn’t working and areas to build on or improve to ensure the service was continuously improving.

The registered manager followed their statutory responsibilities to submit notifications and adhere to the Duty of Candour regulations. They maintained honest and open communication with people, relatives and other stakeholders when important events involving people using the service occurred. The service worked in partnership with other agencies such as the local authority, Police and health and social care professionals’ in response to significant events in people’s lives, to help improve people’s support.