This inspection took place on 10 and 12 December 2018 and was announced.

Mencap – Taunton Deane Support Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing including supported living. It provides a service to older and younger disabled adults as well as people on the autistic spectrum. At the time of the inspection,18 people were receiving support we regulate. Others required guidance with medicine administration and other types of support. There were options to have up to 24-hour support from staff because there were sleep-in facilities in some of the homes.

“The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

.

At this inspection we found the service remained Good.

Why the service is rated good

People received care from staff who knew them incredibly well. The people were involved in decisions about their care and these were respected. If they were unable to be involved then the relevant individuals were asked to decide on their behalf. The staff continuously were finding ways to share the information with people and used different communication methods. Feedback from people informed us about how well cared for they felt.

Care and support was personalised to each person, which ensured they could make choices about their day to day lives in line with their needs, hobbies and interests. Information about people's preferences were gathered in detail prior to them receiving support. Time was provided for new staff to learn about people’s care through the care plans. However, one type of document had not been obtained to inform the person’s care and support needs. This was rectified by the management following the inspection.

People’s privacy and dignity was respected by staff and their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received.

The service was responsive to people’s individual needs. Although activities were not part of our remit we saw these were personalised to each person’s preferences and hobbies. People and staff felt there were enough staff all aspects of their care. This had been improved recently by the management.

Interactions were kind and caring. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. Most medicine were managed safely. People were protected from abuse because staff understood how to keep them safe and were sure action would be taken if any concerns were raised. There was a system in place to manage complaints and people felt listened to.

The service continued to ensure people received effective care. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People who required special support or equipment to eat had their needs met and healthy eating was promoted. Staff had most of the skills and knowledge required to effectively support people. Staff did not have training to provide some specialist support for one person. This was resolved after the inspection. People told us their healthcare needs were met and staff supp

This inspection took place on 26 May 2016 and was carried out by one inspector. The location provides a supported living service to people with a learning disability living in their own homes in the community. The provider was given 48 hours’ short notice of inspection to ensure the manager (or a suitable deputy) would be available to meet us at the provider’s office and also to make arrangements for us to visit some of the people in their own homes.

The service is registered with the Care Quality Commission (CQC) for the provision of personal care in people’s own homes. This includes assistance or prompting with washing, toileting, dressing, eating and drinking. We call this type of service a ‘supported living’ service. At the time of the inspection the service supported 36 people living in single occupancy and shared occupancy houses, flats or bedsits in Taunton, Chard, Street and Frome. Personal care was provided to 11 of these people. The service also provided other forms of social care support that are not included within CQC’s registration requirements for a supported living service. For example, in addition to personal care, the service also assisted people with their housekeeping, shopping, attending appointments and other independent living skills.

The service was responsible solely for the provision of people’s support services and not for the provision of their premises. This meant people’s personal care was provided under a separate contractual arrangement to their housing provision. Accommodation was provided by separate housing providers or landlords, usually on a rental or lease arrangement. People could choose an alternative service provider if they wished. Some of the people received support from more than one support service provider. People who used the service had varying degrees of difficulties and support needs, ranging from mild to severe learning disabilities and autistic spectrum conditions. Some people had complex needs and required 24 hour support, whereas others were relatively independent and just needed assistance for a few hours each day.

The service had 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 manager was on annual leave during the week of our inspection. We therefore agreed to meet with another of the provider’s area operations managers who knew the service well. The area operations manager told us the service philosophy was “To have a stable team supporting individuals in the best possible way, to maintain their health and wellbeing and promote their independence”.

People told us they were happy with the personal care and support they received from the service. One person said “They are very kind. I’m very happy”. Another person said “Staff help me to shower but I get dressed myself. They are alright and always turn up on time”. The relative of a person with complex support needs said “They are doing a great job, I’m very happy. [Person’s name] is always happy, clean and well fed”.

We found staff were motivated and committed to ensuring people received the agreed level of support. Each person had a core team of support staff specifically assigned to them. This ensured people were familiar with the staff who supported them and the staff understood their needs and preferences. Staff were available to support people with personal care when needed, but the service tried to encourage people to be as independent as possible. This boosted people’s confidence and self-esteem and enabled them to become much more self-reliant and independent.

People and their relatives told us the management and staff were very accessible and approachable. They said they cou

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008  and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

At our last inspection in February 2014 we did not identify any concerns. This inspection was announced at short notice.

Mencap – Taunton Deane Support Services provides support with personal care to people with a learning disability who live in their own individual homes, as tenants, in the community.  At the time of our visit there were seven people receiving personal care from the service in line with the hours commissioned by the local authority.  People’s homes are within Taunton and the Chard area.

When we visited there was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has a legal responsibility for meeting the requirements of the  law; as does the provider. 

People said they felt safe and staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised.  Risk management was important to ensure people’s safety.  Measures to manage risk were as least restrictive as possible to protect people’s freedom.  Staff understood the Mental Capacity Act (2005) and how it applied to their practice.  We found the service to be meeting the requirements of the Mental Capacity Act (2005).  

Care files were not always presented in an orderly and easy to follow format. However, staff did not express any concerns and were able to confirm that they knew what people’s current needs were. 

People received personalised care and support specific to their needs and preferences.  They were encouraged to prepare their own meals to develop their skills and to promote their independence.  Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

Staff relationships with people were strong, caring and supportive.  Through our observations and discussions, we found that staff were motivated and inspired to offer care that was kind and compassionate.

Staffing arrangements, which included recruitment, were specific to people’s individual needs.  Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.

People’s views and suggestions were taken into account to improve the service and the organisation recognised the need to increase social inclusion for people with a learning disability. 

Staff spoke positively about how the registered manager worked well with them and encouraged team working. 

A number of methods were used to assess the quality and safety of the service people received.