30 August 2016
During a routine inspection
The Gate is registered as both a supported living service and a domiciliary care service for people with learning disabilities and associated complex needs living in their own homes. At the time of this inspection the service was supporting four people. The support packages ranged from 11 hours to 53 hours per week.
The service did not have a registered manager. However, the service was actively looking to appoint a manager and while this process was taking place the nominated individual, who was one of the managing directors for the organisation was acting as the manager. 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.
People we visited told us that the service had really helped them to achieve their independence and increased their confidence. They were very complimentary about the staff that supported them. People we spoke with said they would definitely recommend the service to others.
There were enough skilled and experienced staff and there was a programme of training, supervision and appraisal to support staff to meet people’s needs. Procedures in relation to
recruitment and retention of staff were robust and ensured only suitable people were employed in the service.
The acting manager was aware of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). There were policies and procedures in place and key staff had been trained. This helped to make sure people were safeguarded from excessive or unnecessary restrictions being place on them.
Medications procedures were in place including protocols for the use of ‘as and when required’ (PRN) medications. Staff had received training in medication management and medication was audited in line with the provider’s procedures.
There was good guidance for staff regarding how people expressed pain or discomfort, so they could respond appropriately and seek input from health care professionals, if necessary. People had access to a good range of health care services and staff actively advocated for people if they felt health care services were not as responsive as they should be.
People were encouraged to make decisions about meals, and were supported to go shopping and be involved in menu planning. We saw people were involved and consulted about all aspects of their care and support, where they were able, including suggestions for activities.
We observed good interactions between staff and people who used the service. People were happy to discuss the day’s events and one person told us about their likes and interests. One person told us how they enjoyed meeting with friends and had a keen interest in cars and motor cycles.
People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it.
They had systems in place to assess and monitor the quality of the service and to continually review safeguarding concerns, accidents and incidents. Where action plans were in place to make improvements, these were monitored to make sure they were delivered. We saw copies of reports produced by the acting manager and by an external assessor. The reports included any actions required and these were checked each month to determine progress.