About the service.

Frances Taylor Foundation Homecare Services provides support and personal care for people with learning disabilities who live in their own accommodation. This was people living in their own accommodation or in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support. Not everyone using the service receives a 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 the inspection the service provided personal care to six people in their own homes.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

At the last inspection the service was rated as Good. The inspection report was published on 23 June 2016. The service remains Good, although we identified improvements were needed to ensure all risks to people were fully assessed and recorded. More information about this is in our full report below.

People’s experience of using this service:

People received safe care, with the exceptions of improvements being needed to assessing risk and reducing the likelihood of any harm to people. We made a recommendation about this. People said they felt safe with staff. The staff had a good awareness of people’s rights regarding safeguarding procedures.

People received individualised care and support which was person- centred. Each person or their relative said they were very satisfied with the service provided. People told us their care needs were discussed with them so they got the care they needed. One person, for example said, “They (staff) know me well and know how I like to be helped.” Staff provided support to people at the agreed times. People said they had built good relationships with the staff who they valued. For example, one person said of the staff, “The people we get are very lovely people. All the staff are marvellous.” We observed people and staff together and it was clear people looked to the staff for reassurance and support. For example, people asked if a staff member could be present when we spoke with people on their own. People said they were able to choose which staff supported them and this was considered in the provider’s assessment of people’s needs.

People received support with social and recreational activities which they enjoyed. For example, people told us they went on holiday and day trips with staff support. People were supported to develop independence and to have control over their lives, such as choosing what they would like to do and having access to community facilities.

The provider and staff were committed to promoting people’s rights to a good standard of care, to providing choice and having equal access to facilities in the community. Staff were motivated to learn and to enhance the quality of life and experiences of people they supported. For example, one member of staff said, “I am passionate about what I do. I can make a difference to people. We can help build confidence and help people to do new things. It is a joy to come to work.”

Staff were well trained and supervised. Staff felt supported and said they worked well as a team.

The views of people and their relatives were obtained using survey questionnaires and the results of these were used to make improvements.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.

The inspection took place on 10 May 2016 and was announced.

Frances Taylor Foundation Homecare Services provides support and personal care for people with learning disabilities who live in the community, either in their own accommodation or with family or friends. Support is tailored to people’s assessed needs and requirements. On the day of inspection the service was supporting 53 people. The provider, The Frances Taylor Foundation, is a national, faith based charity which provides residential and community support to people with learning disabilities and older people. The service was last inspected on 28 October 2013 with no concerns found.

The service has an established registered manager who has managed the service for some time. 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.

Staff had a good understanding of the principles of the Mental Capacity Act 2005 and were able to describe how they sought consent and offered choice to those without mental capacity. However, care plans for those lacking capacity did not contain sufficient information or assessments to underpin the decision making processes for these people and this is an area that needs improvement. The provider has recognised this and has already responded by adding a section on mental capacity to the support plans.

Staff had received training in safeguarding adults and had a good understanding of their role in keeping people safe, how to recognise abuse and report any concerns.

People told us they felt safe and a member of staff described the service as, “Very safety conscious.” There were environmental and individual risk assessments in place to guide staff and minimise risk of harm to people. There was a process in place for recording and monitoring accidents and incidents with action plans to prevent recurrence. Accidents and incidents were discussed at staff meetings so that the team could learn from them and prevent future incidents of a similar nature.

There were sufficient numbers of skilled staff employed to meet the needs of people and safe recruitment practices ensured that staff employed were suitable to work with people. Visits were planned so that there was sufficient travelling time for staff between calls. Two people and one relative told us that staff were always on time. Another told us that they received a phone call if staff were going to arrive late or early and described the service as, “Very organised.”

Some staff were trained to give medication; individual support plans provided guidance to staff on how to administer medicines to people and how to support those who self-medicated. Medication records demonstrated that people were given their medicines as prescribed.

People told us that staff followed correct infection control procedures. They told us that staff washed their hands and wore personal protective equipment such as gloves and aprons when giving personal care.

There was an induction programme and training plan in place. In addition to this all staff were in the process of completing a nationally recognised qualification in care regardless of their existing skills and experience to ensure that the entire team was up to date and practicing at the same level. Staff were supported and developed through regular supervision and appraisals.

Staff spoke knowledgeably and care plans were detailed. Staff explained that they would recognise if a person was not eating and drinking sufficiently or experiencing difficulties and that they would support them to manage their nutrition appropriately

Staff recognised ill health and supported people to attend routine appointments or access emergency healthcare services if required. People were often sup

During our inspection we spoke with three people who used the service, the registered manager and two support workers.

People told us they enjoyed their visits from the staff and participated in a range of activities together. One person we spoke with told us “I love it, they help me with my independence” another person we spoke with told us “they are all so nice and they come and visit me weekly and help me with anything I want to do”.

The Staff we spoke with felt they worked well as a team and had a very supportive manager. One member of staff we spoke with told us “We provide great help and support to our service users and feel we offer a unique service, I love working here”.

We also looked at care plans, risk assessments, staff records and policies and procedures.

During our inspection we found that systems for consultation, interaction and communication were effective and people were treated with respect and dignity. As far as practicable, they were involved in making decisions about their individual support.

We found that comprehensive and well maintained care plans enabled care workers to meet people's assessed support needs in a structured and consistent manner.

We found that people receiving a service were protected, through robust policies and procedures and effective staff training relating to safeguarding vulnerable adults.

We found that the service had systems in place to ensure staff received the necessary training and support to meet the identified care needs of people living in their own home.

We found that the agency had a system in place to identify gaps in service delivery, address the shortfalls and monitor the improvements.

Positive comments received from people receiving a service indicated satisfaction with the care workers and the support services provided:

“I’m happy, the carers all know me and I have all the help I need. The manager has been very supportive and it’s reassuring to be able to call him if I’m worried about anything”.

“I’ve been with the agency for over eight years and in that time my needs have changed but so has the support that I get. Generally I’ve been very satisfied with the care I receive but sometimes it can be difficult when new faces turn up”.

We were told that, in accordance with their identified wishes and individual support plans, people are encouraged and enabled, as far as practicable, to make choices about their daily lives.

We did not speak to anyone currently receiving support from Frances Taylor Foundation Homecare Services, however we received positive feedback from the Local Authorities who commission services for people through the agency.