About the service:

Footsteps Care Outreach Limited provides care and support to people living in a ‘supported living’ setting so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Footsteps Care Outreach Limited 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 take into account any wider social care provided. At the time of this inspection, two people were receiving a regulated activity.

People’s experience of using this service:

• People were protected from avoidable harm and abuse.

• People’s risks were assessed, and plans were in place to minimise the risks.

• The provider recruited staff safely.

• Staff were supported to carry out their role with training, supervision and appraisals.

• People were supported with their healthcare needs and their medicines were managed safely.

• The provider carried out an assessment of people’s care requirements before they began to use the service to ensure they could meet their needs.

• Relatives and other relevant professionals were involved in decisions about care.

• Staff understood how to meet people’s equality and diversity needs.

• People’s privacy and dignity was promoted, and they were encouraged to increase their level of independence.

• People received personalised care which included their preferences and choice of activities.

• People’s communication needs were met.

• Complaints were dealt with appropriately.

• People and staff were asked to provide feedback about the quality of the service.

• Quality checks were carried out to identify areas for improvement.

Rating at last inspection:

• Good (report published on 10/08/2016).

Why we inspected:

• This was a scheduled inspection based on the previous rating.

Follow up:

• We will continue to monitor the service through the information we receive.

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

The inspection took place on the 1 June 2016 and was announced. The provider was given 48 hours’ notice because the location was a supported living service for adults who are often out during the day and we needed to be sure that someone would be in.

Footsteps Care Outreach Limited is a service providing respite support to young adults with a learning disability.

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.

People were kept safe in the service and staff followed people’s risk assessments to ensure they were safe in the service and when out in the community .

Staff were knowledgeable in safeguarding procedures and told us they would report concerns to the registered manager or deputy manager. Staff said they would approach the regulator CQC if they wanted to whistleblow.

People’s medicines were managed safely and staff were trained in the safe management of medicines and controlled drugs. The deputy manager told us that staff had to demonstrate they could administer people’s medicines safely before working with people.

Staff were supported with a through induction and had to shadow senior staff before working with people at the service. Records showed that staff were offered mandatory training and specific training to give them the skills needed to support people in the service. Staff told us there were always opportunities to learn more and to keep their skills up to date.

Records showed that staff received supervision and an appraisal so they knew how they were performing and to discuss any issues with their work or future training needed.

Staff demonstrated they understood the principles of the Mental Capacity Act 2005 and how to support people in making their own decisions. Staff told us they offered people choices of food and clothing to help them be involved in the decision making process.

A relative told us that staff were caring and took the time to know people. People’s privacy and dignity was respected.

People’s care plans were personalised and all aspects of care were documented which made the care personal to them. People’s preferences were recorded and staff told us in detail how they responded to people if they had a seizure which corresponded to the records we looked at.

Staff said the registered manager and deputy were approachable and gave positive feedback on the work they did for people.

Staff met with management regularly in team meetings and if staff were unable to attend information was shared with staff. Checks and audits were not recorded which meant they could not be verified as being done. We have recommended the service follow best practice when auditing.

Staff respected people's privacy and dignity at the service while delivering personal care.

The service encouraged people's independence and praised this to people and their relatives when progress was made.

Care plans at the service were detailed and met people's complex needs. Risk assessments were also very specific and protected people from being exposed to risks and gave staff clear guidelines on how to minimise risk.

Staff knew the people they cared for well and planned in advance for when they arrived. Staff advised they would have people's rooms and food shopping ready for their arrival.

People were protected from the risk of abuse and would escalate concerns to the registered manager or notify relatives. However staff had not completed recent safeguarding training. One relative said "staff will call me if they notice anything is not right."

Staff were skilled to look after the people in their care and had received relevant training to support this. There were always staff people knew who were available and we did not see any evidence of agency staff being used.

Quality of the service was checked through management and staff meetings. Feedback was obtained from relatives verbally when they called the service. One relative said "X likes it here and the staff are all really good there."