About the service: Integrated Care and Support Services (I.C.A.S.S) is a domiciliary care agency that provides support to young adults with complex needs; the service provides support to people in their own homes as well as offering short break and respite services. At the time of our inspection 12 people were receiving support with personal care.

People’s experience of using this service:

The management team and staff at I.C.A.S.S pride themselves on supporting people to access a range of social activities to allow them to live as normal a life as any other person. The provider’s ethos is “everyone is equal and we should focus on ability not disability”. People are at the forefront of the service and encouraged and supported to make decisions about how aspects of the service should run. The ‘service user led’ approach taken by the management team has allowed people to develop the confidence to offer their views and feedback.

People had access to a wide range of social activities and were instrumental in the planning and development of the services’ activity planner. Activities were developed to help promote independence, skill development, social inclusion and healthy lives.

Staff were motivated to deliver care that was person-centred and based on people’s needs and preferences. People were encouraged to be independent and supported by staff to do so. Positive comments were received regarding the caring approach of the staff team and how well they knew people’s needs. Positive relationships had been developed between staff and people using the service. People were treated with kindness, compassion and respect and staff interacted well with people.

Family members told us they felt their relatives were safe when being supported by staff and wee confident they were well looked after. Risks people faced were assessed and those identified were safely managed by competent staff. Where people required support with medication this was managed safely and family members confirmed people received medication on time. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. The environment was clean and safe and people had access to appropriate equipment where needed.

Enough suitably qualified and skilled staff were deployed to meet people’s needs and keep them safe. Staff received a range of training and support appropriate to their role and people’s needs. Staff told us they received a good level of support from the management team and were encouraged to develop within their roles.

People’s needs and choices had been assessed and planned for. Care plans identified intended outcomes for people and how they were to be met in a way they preferred. People were supported to have sufficient food and drinks and encouraged participate in meal preparation where appropriate. The healthcare needs of people were met and understood.

The leadership of the service promoted person-centred care and a positive culture within the staff team. Staff and family members described the management team as supportive and approachable. By using effective quality assurance systems and working closely with other organisations and community groups, the management team showed a desire to continuously improve on the service provided.

Rating at last inspection: Good (report published September 2016)

Why we inspected: This was a planned comprehensive inspection based on the rating from our previous inspection.

The inspection was announced and took place on the 12 July 2016.

The service is registered to provide personal care to people within their own home in the St Helens area. At the time of the inspection, there were two people using the service.

A registered manager had been in post within the service since November 2014. 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.

People were protected from the risk of abuse. Staff had completed safeguarding training, and were aware of how and when to report any concerns they may have. Records contained examples where appropriate action had been taken to keep people safe.

There were sufficient numbers of staff in place to meet people’s needs. People commented that the staff arrived on time, and that care calls were not missed. They also confirmed that staff stayed the full amount of time. Robust recruitment measures were in place to ensure that staff were of suitable character.

Accidents and incidents records showed that appropriate action was taken to keep people safe, and to minimise the risk of issues reoccurring. This ensured that people’s safety was maintained. Risk assessments which were in place helped to ensure people safety.

Staff had undertaken relevant training to enable them to effectively carry out their role. This included training that helped them to manage specific needs related to people’s health needs. There was an induction program in place for new staff to ensure they had the skills they needed.

Staff had a good understanding of the Mental Capacity Act 2005, and their roles and responsibilities in relation to this. People commented that they were given choice and control over their care by staff. This ensured that people’s rights and liberties were being protected.

People and their relatives commented positively on how staff conducted themselves, stating that they were kind and respectful. People were consistently supported by the same staff, which helped to facilitate the development of positive relationships.

People’s care records contained personalised information around their care needs. This meant that staff had access to clear and up-to-date information around how they should support people. This included information around people’s interests, hobbies, personal histories and preferred daily routines. Information was reviewed on a routine basis so that it remained up-to-date.

People confirmed that they were supported to engage in activities. This protected them from the risk of social isolation, and helped maintain their involvement within the local community.

Audit processes were in place around care plans and staff training. Where actions were identified there was not a clear system in place to show when these needed to be completed by, or whether these had been completed. The registered manager confirmed that they were looking at implementing a new system around this. Appropriate action had been taken in response to accidents and incidents to help keep people safe and to minimise the risk of reoccurrences.