City Care Partnership provides domiciliary care to young people over the age of 16 and adults with a learning disability and autism.

This was an announced inspection on the 04 October 2016. Two days prior to the inspection, we contacted the provider and told them of our plans to carry out a comprehensive inspection of the service. This was because we needed to be sure that someone would at the office.

The service had a registered manager in place at the time of our inspection. 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.

Policies and procedures were in place to safeguard people from abuse and staff had received training in safeguarding adults. Staff were able to tell us how to identify and respond to allegations of abuse. They were also aware of their responsibility to ‘whistle blow’ on colleagues who they thought might be delivering poor practice to people.

We found recruitment procedures were robust, people and family members were involved in the selection process which meant new staff should be suitable to look after the people who used the service.

People were encouraged to self-medicate if they could. Staff were trained in medicines administration and had policies and procedures to follow good practice. The administration of medicines were safe.

Risk assessments did not prevent people from enjoying their lives but helped them keep safe.

Staff were trained in techniques to de-escalate any behaviours that challenged to help keep people who used the service safe.

People who used the service told us they liked where they lived and were involved in running the home. This included having their say in meetings and also keeping the home clean, shopping and cooking.

People were supported to take a nutritious diet and sufficient fluids to remain healthy.

New staff were inducted to the service and enrolled on the care certificate. Staff who had completed this induction or worked at another service had their abilities assessed and enrolled on any training to support them to look after the people who used the service. Training was extensive, tailored to staff and people who used the services needs and relevant to the role they performed. Supervision and appraisal was ongoing and tied to the services quality assurance framework to provide a better service for people.

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards.

We observed that staff knew the people they looked after well and had a good rapport with them.

The service matched people who used the service with a staff member who had similar interests which enabled them to do what they liked together.

We saw that the religious needs of people who used the service were recorded and people had the opportunity to follow their faith if they wished.

People were able and encouraged to attend activities in a group or as individuals. We saw the service took care in helping people with Autism or learning disability to attend new activities in a planned way to ensure all went well. There were many records of what people enjoyed. People were given opportunities to attend work or college if they wished.

Staff were able with training and specialised equipment to support people who had problems with verbal communication.

People who used the service told us they felt able to complain. The complaints procedure was available in an easy read format and there were photographs and contact details of managers, which gave people a clear message who they could complain to.

The assessment process helped ensure people who used the service were aware of what was happening and they were given sufficient time to become used to moving in

Most of the people using this service had limited verbal communication skills due to their learning disability. However we were invited to speak with three people using the service who had full verbal ability and had consented to speak with us. All three people were supported by their care worker. We also spoke with the registered manager and six members of staff.

People spoken with told us they were happy with the service provided and they were encouraged to make choices about how they spend their time. They told us that they felt well supported and listened to by staff and they liked the staff.

We reviewed the care records for two people. We found that care records were detailed, comprehensive and clearly identified the needs of the person in relation to their learning disability and the support they required to develop their independent living skills.

We looked at the way complaints were handled by the agency and saw that people were listened to and appropriate responses were given.

We looked at staff records and saw that staff had been robustly and appropriately recruited.

All staff spoken with were positive about the standard of care provided by the agency and the support they received from the management team.

We looked at a variety of records at the office and saw that these were regularly updated and stored appropriately.

Most people using the service had limited communication skills due to their learning disability but we were invited to speak with two people using the service who had full verbal ability and both had consented to speak with us. We also spoke with support (care) workers.

One person using the service told us, “I think the service is brilliant. I am very happy with the support I get from my support workers, they are great. We talk about my health plan and things I want to do all the time. I also have a job which I really like.” Another person told us, “I wasn’t happy a while back about the support I was getting so I told them about it. It was all sorted and now things are really good.” We asked this person if they would have the confidence to raise concerns again if they weren’t happy and they told us “I certainly would.”

Each person using the service had their own support plan. These support plans were known as an ‘Essential life plan’ (ELP) and consisted of eight files of different information that collectively made up the persons care plan and provided staff with detailed guidance on how each person was to be supported. For example, as well as the ELP the files held risk assessments, behavioural strategies, daily logs (communication records) and health action plans.

We found that people using the service were safeguarded from potential abuse.

We found that staff received appropriate training.

The provider had systems in place to monitor the quality of service.