About the service:

Real Life Options - Tyneside Domiciliary Service is a domiciliary care agency which provides care to people living in their own homes. Most people lived in supported living style accommodation because they required care up to 24 hours a day. It also provided an outreach service to adults and children. At the time of our inspection 31 adults and 5 children with learning disabilities and/or autism used the service throughout Newcastle, South Tyneside and Durham.

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

People’s experience of using this service:

• Staff knew how to recognise the signs of abuse and reported their concerns in line with the providers safeguarding policy and procedures.

• The service was safe and the risks people faced were assessed and reduced wherever possible.

• The 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/or autism using the service can live as ordinary life as any citizen.

• Staff focussed on giving people opportunities to become more independent.

• People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.

• The service was flexible and provisions were changed and adapted to meet people’s needs and choices. Good communication with external professionals ensured services achieved positive outcomes for people.

• People were very well cared for in the comfort of their own homes. Staff knew the people they supported well and they treated people with kindness, patience, dignity and respect.

• People participated in pastimes that were motivating and meaningful to them. Staff arranged activities to maintain people’s links with their local community and those which provided opportunity for social interaction with family and friends.

• The provider ensured the quality and safety of the service through regular checks and audits.

• The service met the characteristics for a rating of good in all the key questions we inspected. Therefore, the overall rating for the service after this inspection remained good.

Rating at last inspection:

At our last inspection the service was rated good. Our last inspection report was published on 9 August 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received based on the last rating.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in line with our inspection programme.

We carried out an inspection of Real Life Options Tyneside Domiciliary Service on 26 May and 6 and 10 June 2016. The inspection was announced. This was to ensure there would be someone present to assist us. We last inspected Real Life Options Tyneside Domiciliary Service in November 2013 and found the service was meeting the legal requirements in force at that time.

Real Life Options Tyneside Domiciliary Service operates from an office in Newcastle upon Tyne. The service provides personal care for adults with learning disabilities, either in their own home or within supported tenancies. At the time of the inspection there were 15 people in receipt of a service. Personal care was provided to people across the Newcastle and County Durham areas.

The service had a registered manager in post. 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 told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults. Alerts were dealt with appropriately, which helped to keep people safe. Incidents and allegations were notified to the local safeguarding team and the provider worked positively with statutory agencies, such as the police, local authority and CQC.

We were told staff provided care safely and we found staff were subject to robust recruitment checks. There were sufficient staff employed to ensure continuity of care and the reliability of the service. Staff managed medicines safely.

Staff had completed relevant training for their role and they were well supported by their supervisors and managers. Training included care and safety related topics and further topics were planned. Care professionals commented on the skills of staff and the effectiveness of the service in meeting people’s needs

Staff obtained people’s consent before providing care. Staff were aware of people’s nutritional needs and made sure they were supported with meal preparation, eating and drinking. People’s health needs were identified and where appropriate, staff worked with other professionals to ensure these needs were addressed.

People spoke of staff’s kind and caring approach. Staff explained clearly how people’s privacy and dignity were maintained.

Assessments of people’s care needs were obtained before services were started. Care plans had been developed which were person-centred and had sufficient detail to guide care practice. Staff understood people’s needs and people and their relatives expressed satisfaction with the care provided.

Events requiring notification had been reported to CQC. Records were organised and easily retrieved.

There were systems in place to monitor the quality of the service, which included regular audits and feedback from people using the service, their relatives and staff. People’s views were sought through annual surveys, meetings, care review arrangements and the complaints process. Action had been taken, or was planned, where the need for improvement was identified.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Anita Main's name appears because she was still a Registered Manager on our register at the time.

People who were able to had signed their support plans to give consent to their care. Staff we spoke with said they always asked people for permission before delivering any care. Where people were unable to consent the provider had systems in place to make decisions in their 'best interests.'

People had their needs assessed and the assessment was used to develop personalised support plans. One person and one relative we spoke with told us they were happy with the care provided.

People had their medication administered by staff who had completed appropriate training and had been assessed as competent.

The provider had systems in place to ensure that prospective employees were suitable to work with vulnerable people. One person who used the service said they were happy with their care staff.

People who used the service and family members were asked for their views about the service and these were acted on. There were systems in place to check on the quality of the service being provided.

People were given information about the complaints procedure in a format that met their needs. One person and one family member we spoke with knew how to complain if they were unhappy with their support. One family member commented, “The care is brilliant”, and, “I have no concerns at all.”