We carried out a comprehensive inspection of Independent Lives (Disability) on 19 and 21 December 2017.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides support to adults across the whole population. At the time of the inspection 52 people were using the service.
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.’
The service was last inspected on 16 and 18 February 2016 and was rated ‘Good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.
At the last inspection on 16 and 18 February 2016, we asked the provider to take action to make improvements as we found people did always have safe and proper support with their medicines. At this inspection we checked to see if the provider had taken actions to address these issues and found that they had and people were receiving safe support with their medicines.
The service had systems and processes in place to encourage and enable accessible and open communication with people who used and were connected to the service. However, many people we spoke with said that communication was not very good and they felt their views and experiences were not always acted on to improve the service. This is an area of practice in need of improvement.
The service had sufficient staff and people’s needs were being met but some people told us care calls did not always take place at their preferred times. The service was aware of this and had invested in resources to improve the service in this respect.
There was a complaints policy in place and people told us they knew how to raise a complaint and felt confident to do so. Some people felt like complaints were not dealt with properly and issues were not resolved. The service aimed to resolve all complaints to everyone’s satisfaction. The service was open and transparent and offered apologies when people had made complaints.
There were safe recruitment practices and systems and processes in place to keep people safe from abuse. Accidents or incidents which were responded to quickly to put actions into place to keep people safe. The registered manager reported incidents and accidents onto other relevant partner agencies for review and agree any necessary actions to keep people safe.
The organisation had an Equality and Diversity policy in place. Staff also received training to help them understand the importance of recognising and preventing discriminatory abuse against people and supported people to understand their rights. People, equipment and people’s homes had risk assessments in place to keep people safe. The service ensured that people were involved in this process and restrictions on their independence were minimised.
Staff received infection control training and used Personal Protective Equipment (PPE) when supporting people with personal care tasks. Any hazardous waste was managed correctly. Staff had received food hygiene training to safely support people with any food preparation and handling support.
Staff received Mental Capacity Act 2005 (MCA) training and understood the relevant consent and decision-making requirements of this legislation. People or a relevant person acting in their best interests had signed their support plans to say they consented to their care. People were involved in regular reviews of their support and could see their care plans whenever they wanted.
Staff had regular training and updates to be able to have the right skills and knowledge to be able to meet people’s assessed needs. Staff had regular spot checks, supervisions and appraisals to help them to understand their roles and responsibilities.
The service assessed people’s physical, psychological and social needs to ensure they were able to meet their preferred support outcomes. Where appropriate family members and other relevant people were also involved to make sure people got the support they wanted and needed. Staff respected and did not discriminate when people had a support need or made a particular decision related to their protected characteristics under the Equality Act 2010.
The service used technology to enhance the delivery of effective care. People’s care plans contained details of any medical and health care support needs. If necessary, staff would support people to access healthcare services. People had effective support to eat and drink and maintain a balanced diet.
People told us staff were caring and they felt involved in their care. Staff supported people in a kind and compassionate manner. People’s care plans contained information about their personal life histories to help staff quickly get to know about who a person was as an individual. People’s privacy and dignity was respected and they were encouraged to be as independent as possible when having support.
People’s personal information was treated confidentially in line with the principles of the Data Protection Act. People contributed to the planning of their care and support. People’s care plans included information about what was important to them that staff needed to know and do when supporting them.
People’s care plans identified how to meet the communication needs of people with a disability or sensory loss. The service ensured the accessibility of information about care and support for people with a disability or sensory loss related communication need.
There was a clear vision and set of values in place to deliver high quality and person centred care to people. There were management processes to outline expectations for staff responsibility and accountability. There was positive, supportive, inclusive and open team culture. Promotion of staff well-being and equality and diversity rights were a priority. Staff felt respected and involved in developing the service.
There were quality assurance and information governance systems in place to monitor the quality and safety of the service. Actions for improvement or areas of success to build on were identified and carried out in a timely manner.
The registered manager had submitted notifications to the Care Quality Commission (CQC) regarding all notifiable events that had occurred at the service and demonstrated their awareness of the Duty of Candour CQC regulation. The service shared information and worked in partnership with the local authority, police and healthcare professionals to implement actions and improvements in response to any notifiable incidents.