About the service:

Banya Family Placement Agency Ltd is also known as Banya Shared Lives Scheme. The service provides support to young people and adults who are living with a learning disability and have mental health needs. The service also recruits adult placement carers who offer care and support in their own homes. At the time of this inspection, nine people were using the service.

People's experience of using this service:

¿ People had their medicines as prescribed, however the medicine administration records contained gaps and were not audited for accuracy and completeness.

¿ Staff ensured people were protected from the risk of harm and abuse. Staff and carers understood the types of abuse and developed their knowledge through safeguarding training.

¿Risks to people's wellbeing were identified and assessed, a detailed management plan was put in place to mitigate them.

¿ The recruitment of staff and carers was robust. Only staff and carers assessed as suitable to support people were employed and recruited and only after checks were returned.

¿ People were supported to have maximum choice and control of their lives and office based staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿ People and their carers were complimentary about the staff and in the leadership of the service. All commented that staff were kind, caring, compassionate and thoughtful in their approach with them.

¿ People had assessments of their care and support needs. Assessments captured the views and opinions of people’s and their carers. People discussed their likes and dislikes, and these were recorded on their records and used to develop their individual care and support.

¿ People were supported by their carers and office based staff to continue to be involved in activities that met their cultural needs. Office based staff and carers supported people to explore their gender and sexual identities.

¿ People and their carers were involved in and contributed to care planning and in the review of their care.

¿ People received consistent care and support from staff. The registered manager reviewed and monitored the service to ensure it was of a good standard and implemented strategies to improve the quality of the service.

Rating at last inspection: At the previous inspection on 29 June 2016 we rated the service Good. (Report published 12 August 2016)

Why we inspected: This planned inspection was carried out on 11 February 2019 based on the previous rating. At this inspection we found some areas had maintained a Good rating. However, Safe and Well Led had deteriorated to Requires Improvement. This was because there were no processes in place to review medicine administration records for accuracy and no audits of medicines taking place.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We completed an unannounced inspection of the service on 26 June 2016. Banya Family Placement Agency Ltd is also known as Banya Shared Lives Scheme. People live with carers who provided 24 hour personal care and support. Staff also provided care and support to people when required.

The service is registered to provide personal care to people in their own homes at the time of the inspection nine people were using the service. People had complex health care needs and learning difficulties, some of whom were unable to communicate verbally.

At the last inspection on January 2015, the service was meeting the regulations we inspected.

The service has a registered 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 2008 and associated Regulations about how the service is run.

The registered provider supported staff to protect people from harm and abuse. Staff had safeguarding processes in place to follow and assist them to safeguard and protecting people from the risk of abuse. Staff demonstrated their awareness of the signs of abuse and the actions they would take to manage an allegation of abuse. Risk management plans were in place to reduce the reoccurrence of those risks while encouraging safe, positive risk taking.

The registered provider ensured sufficient staff were available to meet people’s care needs. People had regular staff available to them to support them as required. Staffing levels were flexible to respond to people’s needs at short notice or in an emergency. The registered provider had a bank of staff that were able to provide staff cover when required.

Staff had the skills and relevant training to enable them to manage people’s medicines safely. There were regular checks on people’s medicine administration records to ensure people received their medicines as prescribed. Effective systems for the management, administration, ordering, storage, and disposal of medicines were in place.

Staff appraisal, training, and supervision supported them in their role. Staff training needs were tailored to support them to care for people effectively. Staff were provided with opportunities to discuss their training and professional development needs during supervision and appraisal meetings. Staff understood best practice guidance and training used and implemented them to meet the needs of people. Training attended supported staff so that they were effective in their role to care for people and deliver quality care. . The registered manager supported social workers to maintain their registration with the Health and Care Professions Council [HCPC].The HCPC maintained a registry for qualified social workers.

People gave consent to care and support provided by staff. People had information presented to them in a format that they understood so they were able to provided informed consent to receive care and support. The registered manager and staff had an understanding of the principles the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff had an awareness of people’s nutritional needs to maintain their health. Staff provided meals in order to meet people’s preferences and supported people to prepare and make a meal of their choice.

People had access to health care services to meet their needs and professional guidance implemented to maintain their health. Staff ensured people’s care needs were regularly monitored and addressed when they changed.

Staff knew people well, were aware of their personal histories, and understood their likes and dislikes. People, carers and their relatives were involved in making care and support decisions. Staff developed creative ways to involve people in planning their care. Care and support delivered were person centred which in

One inspector carried out this follow up inspection. During our visit we gathered evidence to

answer one of our questions; Is the service well led?

At our last inspection of 29 October 2013, the provider was did not meet the required standard as they did not have a robust system in place for managing people's records and staff did not have access to people's records as they required. We asked the registered manager to make improvements to their records. We found at this inspection that the registered manager at the service had made the required improvements and they had met the required standard.

Is this service well-led?

At this inspection we found care records reflected people's current needs. Staff identified risks or changes in people's care needs and records were updated. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Banya Shared Lives Scheme supported carers who provided care for twelve adults. We found that information about the service was provided to people and their carer’s and it was monitored whether they were supported in a way which they were in agreement with.

We saw that the provider ensured that people were cared for in an environment that was suitably designed and adequately maintained. We found that there were enough staff to support people and their carer’s and that there were procedures in place to manage the workload of the staff. We also found that there was a system in place to respond appropriately if people had any complaints.

Although people’s needs were assessed and their care was planned in a way to meet their needs and ensure their welfare and safety, we found that records were not available to the supervising social worker in order to ensure that people were cared for in line with their care plans. This meant that people could have been at risk of receiving inappropriate or unsafe care.

We found that the provider actively involved people who used the services and in the development of their individualised care plans. One carer said "my support worker always provides me with information and copies of care plans".

The provider sought feedback from people who use the service. One carer said that "they do listen when we bring up issues at the forum".

The provider protected people and their staff. There was evidence of risk assessments and safeguarding policies were in place to protect people who use the services.

Staff were supported with their daily, practice. Staff undertook training relevant to their role within the provider organisation. We were told by staff that they were provided with training opportunities and a training budget was available.