About the service: Barnardo's Brighton & Hove Link Plus Home Support Service is registered to provide personal care for children and young people with disabilities. At the time of the inspection, home support workers were providing a sitting service to provide parents of four children or young people a break from their caring responsibilities.

People’s experience of using this service:

¿ Families and children and young people receiving the service continued to be supported by a tailored care package that met their specific needs and wishes.

¿ The needs of children and young people who received a service and any risks continued to be comprehensively assessed. Care plans were centered on the child or young person. Care plans had been compiled in collaboration with them and their parent or carer and took into consideration the child or young person's preferences likes and dislikes and the wishes of the family.

¿ A commissioner told us, “I have heard first-hand how vital the Home Care Support Service is and how well valued and trusted the carers are. We have received many testimonies reinforcing what impact the carers & the service has had for the family.”

¿ The family, including the child or young person, chose the home support worker who they were matched with and received consistent support from. A parent said to us, “All the team at Barnardo’s are kind, caring and approachable - understanding fully the needs of the whole family - they have supported us for many years now and have seen our child grow and thrive with their support.”

¿ Children and young people were provided with meaningful and individualised activities and outings which they enjoyed such as horse riding, swimming and going to social groups.

¿ Children and young people continued to be supported by staff who had the skills and knowledge to meet their assessed needs, preferences and choices. In addition to mandatory training, home support workers received training tailored to the specific needs of the child or young person they were matched with.

¿ Home support workers knew the children and young people they supported well and treated them and their family members or carers with compassion and respect. A parent told us, “I’ve been using the service for 5 years, it has been the most constant support that I have received over this time, and the support that feels the most reliable and trustworthy.” A feedback form from a parent said, “Our Home Support Worker is such a positive addition to life and to my life. She is extremely responsible and thoughtful, she’s an observant person and I trust her to meet very complex needs. Another feedback form from a parent said, “I feel such a relief knowing is coming for a few hours – it means I can rest if I’ve been up all night, can got to the supermarket or catch up on stuff that has been worrying me.”

¿ Parents told us that the communication between them the home support workers and staff in the office continued to be effective.

¿ Children and young people were protected from harm and kept safe. Home support workers were trained to recognise the signs of any potential abuse and knew what action to take if they had any concerns about people’s safety or welfare.

¿ The service continued to employ sufficient numbers of staff to make sure children and young people's needs were met and for the service to be managed on a day to day basis.

¿ Quality assurance arrangements were in place to seek feedback from staff, people and parents or carers views about the service to make continuous improvements to the service.

This service met the characteristics of Good. More information is in the ‘Detailed Findings’ below.

Rating at last inspection: Good. The last inspection report was published on 15 July 2016.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelin

The service is registered to provide personal care for children and young people with disabilities. At the time of the inspection support workers were providing a sitting service to provide parents and carers of 14 children or young people a break from their caring responsibilities.

The number of hours support that the provider had been commissioned to supply for each child or young person ranged from approximately 100 hours to 650 hours a year. Parents and carers could use these hours as they wished and the times and frequency of the visits were arranged on an individual basis with their support worker. Most parents and carers used their allocated hours for one or two sessions per week. The duration of the sessions varied but typically lasted for one or two hours. Some parents or carers chose to use some of their hours for longer sessions during the school holidays to facilitate outings. The majority of the time support workers worked under the direction and supervision of the parent or carer and delivered a minimal amount of personal care on an as and when needed basis.

The service has 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 and associated Regulations about how the service is run.

The needs of children and young people who received a service had been robustly assessed. Care plans centred on the child or young person had been compiled in collaboration with them and their parent or carer and took into consideration the child or young person’s preferences likes and dislikes. A parent commented “Our support worker knows (child’s name) and the whole family really well, they understand what support is needed, we couldn’t ask for more.”

Parents and carers were able to choose the support worker with whom they were matched and received consistent support from. A parent or carer told us, “We were matched with (support workers name) right from the start and they’ve been with us ever since. They’ve got to know the whole family really well.”

Children and young people were provided with meaningful and individualised activities and outings which they enjoyed. One parent told us, “They love going out with (support worker) they really look forward to them coming they’re always doing stuff together.”

Children and young people were supported by staff who had the necessary skills and knowledge to meet their assessed needs, preferences and choices and to provide an effective and responsive service. A parent commented, “Our support worker has been with us such a long time now; they have a real understanding of (child’s name) and how to support them.” Support workers knew the children and young people they supported well and treated them and their family members or carers with dignity and respect. Parents and carers reported support workers were kind and polite, were punctual, stayed the duration of their allocated time and informed them if they were unable to come to a session.

Parents and carers told us they felt able to raise any concerns but did not have any. They said the communication between them the support workers and staff in the office was effective and the co-ordinator was very approachable.

Children and young people were protected from harm safe. Steps had been taken to minimise risks and staff demonstrated a good understanding of what constituted abuse. One parent told us, “I feel completely confident that (child’s name) is safe in the support workers hands. I have no worries about that at all.”

There were sufficient numbers of staff employed to make sure children and young people’s needs were met and for the service to be managed on a day to day basis.

Robust quality assurance arrangements were in place to seek staff, stakeholders, people and parents or care

We spoke with the service manager, coordinator and two support workers. We joined a visit to a child’s home where we spoke to their family carer. We spoke with two other family carers by telephone.

Support workers’ records were always counter-signed by the family carer. Records held at the office were up to date and reviewed regularly. A support worker told us “we get full information as preparation for working with a person new to us; the support plans are absolutely the basis of care and our inputs influence how they develop.” A parent said “I feel very involved, I can share everything with the service. They see me as the expert and we all work together.”

Staff training records showed staff were up to date with safeguarding training. Safeguarding information was made available to family carers.

Many of the children visited by the service used mobility equipment. Support records contained occupational therapist (OT) assessments and guidance on safe use of equipment. An OT described the service as excellent in their support of families and individual children and in their collaboration with the OTs. However, support staff were not routinely guided to check the servicing status of equipment they used.

Support workers were regularly supervised. Children’s changing needs were discussed fully in supervision. Support workers said they felt very well supported in their roles. Staff training was individualised, because the support workers tended to work with just one family at any time. Some training was sourced from school nurses and other professionals.

The service sent family carers feedback questionnaires about their experience of the service. Feedback we saw from the current year showed high levels of satisfaction. A family carer told us “the relationship with the support worker is the starting point; we have open communication about what helps me and what she is able to do. But I know how to contact (the coordinator) or go further up if I need to.” Another family carer said “the coordinator touches base with us every few months; at first we had lots of meetings before the support worker was even introduced.”

As part of our inspection we spoke with three people whose families received support from the agency, the registered manager, the agencies co-ordinator and three care workers. We also looked at the care records for four children and their families that the service provided support to.

Parents we spoke with told us that care workers treated their families with dignity and respect. They told us that they had been fully involved in the planning of their care and that medicines had been administered safely. They told us they were very happy with the support they and families received.

As part of the agencies quality assurance, one parent wrote;

'My children all love and trust our support worker. They are happy and comfortable with her.'

As part of our inspection another parent told us;

“I am 100% confident in our support worker; she is flexible and completely understands my family’s needs.”

Care workers we spoke with told us that they felt that care plans were detailed and provided them with the information they needed to provide consistent care. They told us that the process of recruitment had been robust and that identity and security checks had been completed prior to being employed. They told us communication was effective and that they had been provided with specialist training in order to meet the specific needs of the children and families they supported.

We did not speak to people who use this agency however feedback in records seen from people who use the agency, their families and the local authority was positive.

Records confirmed that people were happy with the services that the agency delivered and that families were fully involved in planning the care delivered. Children and families were able to choose the people that supported them and when the support was delivered.