We carried out an announced inspection on 4 May 2016.Kings Dock Mill is registered to provide personal care to seven people living in their own homes. People who use the service are provided with a range of hours of support per day in line with their assessed needs. The office base is located within the Kings Dock Mill complex. People who use the service have access to out-of-hours emergency support .
A registered manager was 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.
The people that we spoke with had no concerns about the safety of services. The provider had delivered an extensive training programme for staff and managers regarding adult safeguarding. The staff that we spoke with confirmed that they had attended the training and were able to explain the different types of abuse and what action they would take if they were concerned that abuse or neglect were taking place.
The care records that we saw showed clear evidence that risk had been assessed and reviewed regularly. Risk was reviewed by staff with the involvement of the person or their relative and maintained a focus on positive risk taking to support independence.
Incidents and accidents were recorded electronically and subject to a formal review process which included an analysis that was shared with senior managers.
Staff were recruited following a process which included individual interviews and shadow shifts. Each offer of employment was made subject to the receipt of two satisfactory references and a Disclosure and Barring Service (DBS) check.
Staff were trained in the administration of medicines but because the services were community-based, they were not always responsible for storage and administration. Some people who used the service were able to self-administer their medication, others required prompting. Medication Administration Record (MAR) sheets were completed by staff where appropriate. The records that we saw had been completed and showed no errors or omissions.
Staff had been recruited and trained to ensure that they had the right skills and experience to meet people’s needs. Staff were required to complete an induction programme which was aligned to the Care Certificate.
Staff were trained in a range of subjects which were relevant to the needs of the people using the service. We looked at records relating to training and saw that all training had been refreshed in accordance with the service’s schedule. People using the service and their relatives said that staff had the right skills and knowledge to meet people’s needs.
People’s day to day health needs were met by the service in collaboration with families and healthcare professionals. Staff supported people at healthcare appointments and used information to update support plans. We saw evidence in care records that staff supported people to engage with community and specialist healthcare organisations to support their wellbeing.
We had limited opportunities to observe staff providing support during the inspection. Where we did observe support we saw that staff demonstrated care, kindness and warmth in their interactions with people. People told us that they very were happy with the care and support provided.
People were supported by the same staff on a regular basis and each person had a nominated keyworker. When new staff were being introduced they were required to work along-side a more experienced colleague on ‘shadow-shifts’. This gave people the opportunity to assess whether they wanted the new staff member to be part of their support team.
We saw that staff knew the people that they supported well. When we spoke with them they described the person and their needs in detailed, positive terms. Staff told us that they enjoyed providing support to people and were able to explain how they involved people in making decisions about their day-to-day care and support.
The provider made use of person-centred planning techniques to maximise the involvement of people in the planning process. We saw that the person-centred plans (PCP’s) were produced to a very high standard with words and pictures to aid understanding. The plans had been further personalised by the use of different fonts and coloured paper to reflect people’s preferences.
We saw from care records and PCP’s that people were given choice over each aspect of their service. This choice included; staff, activities and times of support.
The provider encouraged people and their families to provide feedback through a range of formal and informal mechanisms. They issued regular surveys and sought feedback at each review. People and their relatives told us that they fed-back to the registered manager, team leader and other staff on a day-to-day basis.
The staff that we spoke with were motivated to provide high quality care and understood what was expected of them. They spoke with enthusiasm about the people that they supported and their job roles. Each of the staff was positive about the support and quality of care offered by the organisation.
The registered manager and staff were clearly aware of the day to day culture and issues within the service. We saw that they knew the people using the service and their staff well. The registered manager understood their responsibilities in relation to their registration. Notifications relating to people who used the service had been submitted to the commission as required.
The registered manager was available to members of the staff team throughout the inspection and offered guidance and support appropriately. The manager had sufficient systems and resources available to them to monitor quality and drive improvement.
The registered manager and other senior managers had completed a series of quality and safety audits on a regular basis. Important information was captured electronically and used to produce reports. These reports were shared with senior managers throughout the organisation and used at a local level to monitor and drive improvement.