About the service:

Shared Approach Limited provides a supported living service to people with learning difficulties within their own homes so they can live as independently as possible. At the time of the inspection the service was providing personal care to 29 people who were living in their own 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.

People’s experience of using this service:

The service people received was flexible and supported people with limited communication to lead unique and valued lives that incorporated their preferences, cultural heritage and met their needs. Staff knew people well and could tell us how they managed risk and behaviours that challenge that respected the person and supported their dignity. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff told us they had appropriate training, knowledge and support to keep people safe. Observations showed people were comfortable in the company of staff. People and their relatives we spoke with felt confident in the management. They told us there was a caring culture within the service and staffing levels were appropriate.

It was clear staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and life choices. The registered manager told us the low staff turnover allowed positive relationships to be built with people receiving support and strong teamwork to develop. Staff felt well supported and expressed they were happy in their role.

People and their relatives had been involved in the development of their care plans. These were regularly reviewed to reflect people's current needs. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring. Staff files we looked at showed the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they were supported to gain vocational qualifications in health and social care.

There was a complaints procedure which was made available to people and their family. People we spoke with told us they were happy with the support they received. Relatives we spoke with told they were happy with the care and support delivered. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

We noted activities were provided as part of the care people received. Staff told us they supported people to activities that enhanced their physical and mental wellbeing. The service engaged with outside agencies to ensure people received timely healthcare support. Staff received training to ensure people’s clinical health needs were met daily within their home environment. The management team engaged with other agencies to gain updates on legislation, best practice and learn from other providers experiences.

Rating at last inspection:

At the last inspection the service was rated good (published 07 December 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any issues or concerns are identified, we may inspect sooner.

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

The inspection visit at Shared Approach Limited took place on 12 and 13 October 2016 and was announced. The provider was given 48 hours’ notice because the service delivered personal care to people living in the community. We needed to be sure people in the office and people the service supported would be available to speak to us.

Shared Approach Limited supports adults who have a learning disability in Garstang, Morecambe and the surrounding area. The service supports people with their personal care in their own homes and within a college environment. People who use the service have their own tenancies and receive their support from people employed by Shared Approach Limited. Support is provided in line with people's individual needs and can be at specific times throughout the day and night or full time. At the time of our inspection, 57 people were receiving personal care support from the service.

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.

At the last inspection on 17 January 2014, we found the provider was meeting the requirements of the regulations inspected.

During this inspection, staff responsible for administering medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and there were appropriate arrangements for storing medicines.

Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure and would make an alert should they witness abusive practice.

We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service.

The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People’s representatives told us they were involved in their care and had discussed people’s care and were working in people’s best interests. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

We saw regular drinks were available between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were being met. We saw the management team had responded in an effective personalised way to make sure people were supported to maintain good health.

The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at Shared Approach Limited.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People’s activities were arranged by staff who worked at Shared Approach Limited based on their knowledge of people’s likes and preferences.

A complaints procedure was available for people and their relatives. People we spoke with knew how to complain and to whom.

Staff spoken with felt the registered manager was accessible, supportive, approachable, listened, and acted on concerns raised.

The

During our inspection, we saw evidence that people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Staff members were respectful of decisions made by people using services. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One person commented, `I like where I live, I have no problems and I am very happy.` People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements.

We checked records and spoke to people using services and saw that their health and welfare needs were being met by sufficient numbers of qualified and experienced staff. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. Regular surveys were sent to people using services to get feedback on the quality of service being provided and any issues that were raised were addressed in a positive manner and with the full agreement of people using services.

We spoke with two people who used the service who said, "I am happy with the agency" and "I am well looked after and supported with what I want to do". People we spoke with were satisfied with the service they received.

People who used the service felt able to raise any issues with support staff or management.

Plans of care had been developed with people who used the service to take their wishes into account.

Staff were safely recruited to help protect the health and welfare of people who used the service. People told us staff were, "Very nice" and "Staff look after me very well".

As part of this inspection we had the opportunity to meet a number of people who use the service and in some cases, their support workers.

We received very positive feedback about the service from everyone we met. People were very complimentary about the standard of care they received and spoke highly of staff and managers.

People told us that they received support that met their needs and that it was provided in the way they wanted it to be. One person said ‘’They (the staff) help me with everything. They are always there for me.’’

Other comments about staff included;

‘’They look after me and help me.‘’

‘’They are kind and nice.’’

‘’ They bring me breakfast in bed, that’s my favourite thing.’’

‘’They take me to see my sister, I like doing that.’’

‘’(Name removed) has helped me to get SKY, now I can watch the football. I like watching all the sports.’’

As part of the inspection we attended a drop in session for people who use the service which was held at the office. We were advised that these sessions were held on a regular basis. The session was very well attended and it was clear that people enjoyed having the opportunity to come and meet with staff, managers and other service users.

It was apparent that service users were very familiar with staff and managers and that they got along well. We saw people interacting very positively and having a good time. We saw that people who use the service were encouraged to express their views about their own support as well as the service as a whole.