About the service:

This service is a domiciliary care agency that provides care to around 50 people in their own homes.

This service also provides care and support to around 35 people living in six 'supported living' settings where they can live in their own home as independently as possible.

People’s experience of using this service:

The outcomes for people living with a learning disability who used the service reflected the principles and values of Registering the Right Support. For example, people's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People we spoke with gave us positive feedback on the support and services they received. They felt safe and well supported by the staff teams and they told us they had no concerns.

People told us there were enough staff to support them and they judged that they were suitably trained and managed.

People told us they were satisfied with the way the staff helped them to manage their medicines.

We learned that people were protected from cross infection because staff had suitable equipment and training.

The registered manager and the senior team had a good understanding of their responsibilities under the Mental Capacity Act 2005.

People told us that they were asked for consent before interactions.

People had nutrition and hydration included in care plans and told us the staff helped them to eat well.

People told us they were supported to access health care support and to attend appointments. Staff were trained to call on the support of health care professionals for emergencies.

People told us that staff were caring and kind. Staff were trained in person centred care and in all the aspects of privacy and dignity. People could have the support of an advocate if required.

Good assessment of need and ability was in place. Care planning encouraged independence and skills building for some people. Care plans were detailed and people told us they had been involved with writing their plans. The plans included people's wishes in relation to their social life and we saw lots evidence to show that people were supported to go out and to make new friends in the community.

The service had a newly appointed manager who was in the process of registering with the Care Quality Commission. She was ensuring that quality services continued to be delivered.

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

Rating at last inspection:

At the last inspection the service was rated as good. The last report was published in August 2016.

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We noted that although every staff member received annual training in how to move and handle people and objects, no staff members had attended more advanced training. The service used occupational therapists to support them with complex moving and handling.

We made a recommendation that the provider consider further training for some staff in assessing need, formulating moving and handling plans and in checking staff competence. We will follow this up as part of our ongoing monitoring of the service.

We carried out this announced inspection between the 31 May and 29 June 2016.

The Oaklea Trust Supported Living (South Cumbria & Lancashire) provides supported living services in Kendal, Barrow-in-Furness and Blackpool. Supported living services involve a person living in their own home and receiving care and/or support in order to promote their independence. The care people receive is regulated by the Care Quality Commission, but the accommodation is not.

At the time of our inspection there were 37 people receiving personal care from this service.

Up to February 2016 the service was called The Oaklea Trust (South Cumbria and Lancashire). It provided supported living services for people who have a learning disability and domiciliary care to older people and people who required personal care to remain in their own homes. In February 2016 the registered provider reorganised the services it delivers. The service was renamed The Oaklea Trust Support Living (South Cumbria and Lancashire) and changed to solely provide supported living services. The registered provider’s domiciliary care service is now delivered by The Oaklea Trust Home Care & Community (Cumbria).

There was a registered manager employed. 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 who used the service were protected from harm because the staff employed knew how to identify and report abuse.

There were enough staff to provide the support people needed. Staffing levels were responsive to people’s needs and were arranged to support people to follow activities of their choice. The staff were trained to give them the skills to support people.

The focus of the service was on promoting people’s rights and independence. People were given opportunities to gain skills to increase their independence. They made choices about their lives and the decisions they made were respected. Where people were not able to make important decisions about their lives the principles of the Mental Capacity Act 2005 were followed to protect their rights.

People were treated with kindness and respect. The staff knew people well and knew how to provide their support.

People received the support they required to attend health care appointments. They were supported to manage their medicines and to maintain their health.

The service was well managed. The registered manager was supported by local team managers. People knew the managers of the service and how they could contact them if they needed.

The registered manager and registered provider had good systems to monitor the quality of the service. Where areas were identified that required improvement they took action to ensure the quality of the service.

People who used this agency told us the service was “excellent” and one person said, “I couldn’t be without them”. People told us they felt safe with the staff who visited them and said they were treated with respect. No one we spoke with raised any concerns about the service they received. One person said, “I can’t think of anything they need to do to improve”. Another person told us, “I know if there was anything that needed to be changed, they’d sort it out for me”.

When we inspected this service in July 2013 we found that people were placed at risk because some hazards to their safety had not been identified and managed. We also found that some care staff were carrying out tasks which had not been assessed as suitable to meet individuals’ needs.

At this inspection we found the records the agency held had been improved. Hazards to individuals’ safety had been identified and measures put in place to remove or manage any risks. Care plans gave more information about how people wanted their care to be provided. We also saw that there were clear instructions for care staff about the action to take if they identified that the support an individual required had changed. This ensured that individuals’ care plans were updated promptly so they gave the care staff accurate and up to date information about how to support people.

We gathered the views of people who use this service and their relatives by speaking to some people on the telephone and by sending surveys to other people. We received many positive comments about the care staff who worked for the service and about the quality of the care provided.

People told us,

“They”, [care staff], are all brilliant”,

“They are friendly & considerate but also professional”,

And said the staff who supported them, “Could not do anything better.”

People told us they were included in making decisions about the care they received and said they could refuse any aspects of their care if they wished.

When we inspected this service in February 2013 we found that people were placed at risk of harm because not all staff had received appropriate training and support to carry out their duties safely. We found that some hazards to individuals’ safety had not been identified and there was no information for staff about how to protect themselves or the person they were supporting from the risk of harm.

At this inspection we found that people continued to be placed at risk because some hazards to their safety had not been identified and managed. We also found that care staff were carrying out tasks which were not in individuals’ support plans. These tasks had not been assessed as safe or suitable to meet the individual’s needs. As the tasks were not in individuals’ support plans, care staff had no information about the actions they needed to take to ensure they carried out the tasks safely.

The registered manager left the service while we were conducting this inspection. Their name appears in this report because they were managing the regulatory activity at this location when we started the inspection.

People we spoke to told us this was a good service which they would recommend to other people.

People told us they were included in agreeing to the support they received and said they could choose which staff supported them.

People said they felt safe receiving support from this service and told us the staff treated them with respect.

People told us

“It’s a marvellous service”

“Staff listen to me and I tell them what to do”

“The staff know what they are doing, I don’t have to keep reminding them”

“The staff are a great help and it’s lovely to know they are coming.”

People who used this service told us they were very happy with the care provided. They said they had “no complaints” about the service provided but knew who to contact if they had any concerns. People told us they received support from a small team of staff who they knew and who were knowledgeable about the support they required. They told us they were included in decisions about the support provided by the agency. Everyone we spoke with said they felt safe and would recommend the service to other people.

People told us,

“I have 100% confidence in the staff”,

“I look forward to them, [care staff] coming” and said,

“I feel the staff who visit here have been hand picked to suit us.”

We looked at the records the agency held. We found that people were placed at risk of harm because not all staff had received appropriate training to carry out their duties and risk assessments had not been carried out to identify hazards to individuals’ safety and how these were to be controlled.