About the service:

Clearwater Care Group is a domiciliary care agency that provides personal care and support to people with learning disabilities and one older person. At the time of our inspection the service provided personal care to 11 people living in their own homes, some of which were houses of multiple-occupancy in Peterborough, Worcestershire and Staffordshire. The size of the properties meets current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life. The service’s office was in Peterborough.

Not everyone using Clearwater Care Group receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service:

Staff did not always follow the provider’s policy to make sure they only employed staff once they were satisfied of their suitability to work with people who used the service. There were enough staff to meet people’s needs safely. Managers reviewed staffing levels and people needs regularly. Staff worked well together to ensure people were safe and well cared for. They knew the people they cared for well and understood, and met, their needs.

People were protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Staff assessed and minimised any potential risks to people. Staff followed the provider’s procedures to prevent the spread of infection and reduce the risk of cross contamination. The provider had systems in place to enable staff to safely manage people’s medicines.

People received care from staff who were trained and supported to meet people’s assessed needs. Staff supported people to have enough to eat and drink and maintain a healthy weight. They worked well with external professionals to support people to keep well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were involved in making decisions about their care and support. Where people needed additional support to make decisions, staff had referred people to external advocates.

Staff supported people in a sensitive and friendly way. One person told us, “You can have a good banter with the staff here. They’re the best staff you could wish for. They are down to earth.” Staff were respectful when they spoke with, and about, people. They supported people to develop their independence.

Support was person centred and met each person’s specific needs. People and their relatives were involved in their, or their family member's, care reviews. People’s care plans were in the process of being completely revised to ensure they were up-to-date, and more individualised. People’s needs were constantly reviewed, and support adapted as required. Staff encouraged and enabled people to be as active as possible and pursue their interests. People and their families felt able to raise concerns which the provider addressed. The provider had systems in place, including a complaints procedure, to deal with any concerns or complaints

Clearwater Care Group is a supported living service that is registered to provide personal care. At the time of our inspection there were seven people using the service. The service’s office is located in Peterborough. The service supports people living in Peterborough, Yaxley and Kettering.

This announced inspection took place on 13 September 2016.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of our inspection the registered manager was on leave. A service manager was in post providing day to day management support.

Staff had been trained about safeguarding people and knew how to recognise any potential signs of harm. Risk assessments were up to date and helped staff manage any potential risks to people. Appropriate behavioural management strategies were in place to help reduce any potential risks to keep people safe. A sufficient number of skilled, safely recruited and competent staff were in post.

Staff who had been trained and deemed competent, administered people’s medicines safely including medicines prescribed to be given ‘when required’. People’s medicines were managed and stored safely.

Staff were provided with training deemed mandatory by the provider as well as subject specific training according to people’s needs. An effective induction, supervision and mentoring process was in place to support staff in a positive way.

Systems were in place to support people in the event of an emergency such as need to evacuate the premises.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service’s manager, team leader and care staff were knowledgeable about if and when a decision needed to be made that were in people’s best interests.

People were supported by, and they had to access to, those health care professionals and services that they required. People were encouraged and supported to have a healthy balanced diet and adequate hydration according to their needs.

People experienced care that was dignified and compassionate. Staff put people’s needs first and foremost. Advocacy arrangements were used to support those people who had need of this support.

People were involved as much as practicable in developing and reviewing their care plans. Information contained in each person’s care plan was detailed and up to date. Staff respected people’s preferences and individual circumstances. People were supported with various opportunities to be as independent as practicable with a wide range of hobbies and interests.

People, their relatives and staff had access to a complaints process which was provided in an accessible format. People, relatives, health care professionals and staff were encouraged to provide their views on the quality of the service and the care that it provided.

A range of effective audit and quality assurance procedures were in place. This was to help identify what worked well and any area that did not work as well as making any improvements necessary.

The management team fostered and supported an open and honest culture within the staff team. Opportunities to learn from accidents and incidents were taken at every opportunity. People were given many opportunities by the management team and staff to enable them to access and participate in the local community.