About the service:

Communication Independence Limited is registered as a domiciliary care agency to provide personal care. They support people with a hearing and/or a visual impairment or have combined sight and hearing loss and who may also have other support needs, such as physical disabilities, learning difficulties and/or needs relating to their mental health. At the time of the inspection there were seven people using the service.

People’s experience of using this service:

• People told us they felt safe with the support provided from Communication Independence and they were consistently treated with kindness, dignity and respect.

• People knew who to report any concerns to and were happy with the support they received from staff.

• People’s care records contained guidance for staff about how to support people safely and minimise risks to people.

• Staff were trained in their responsibilities for safeguarding adults and knew what action to take if they witnessed or suspected any abuse.

• The service had systems in place to ensure people received their medicines as prescribed. Staff supported people to maintain their health by making appropriate referrals to community health professionals and acting on any advice they were given.

• Staff told us they thought there were enough staff to meet people’s needs.

• People received personalised support from staff who knew them well. People’s likes, dislikes and social histories were recorded in their care records. This helped staff care for them in a personalised way.

• Staff were competent, knowledgeable and skilled. They received regular training, supervisions and appraisals which supported them to conduct their roles effectively.

• 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.

• The provider had an effective complaints procedure in place. People and their relatives knew how to complain if they needed to.

• The provider and registered manager understood the regulatory requirements and monitored the quality and safety of the service on a regular basis.

• Staff told us they enjoyed their jobs; their morale was positive, and they told us the staff team worked very well together.

Rating at last inspection:

The last inspection of Communication Independence Limited was on 9 and 12 January 2018 and the service’s overall rating was good, with one breach in regulation.

Why we inspected:

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

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.

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

Communication Independence Limited registered with the Care Quality Commission in March 2014. Communication Independence Limited is registered as a domiciliary care agency to provide personal care supporting people have a hearing and/or a visual impairment or have combined sight and hearing loss and who may also have other support needs, such as physical disabilities, learning difficulties and/or needs relating to their mental health. Not everyone using Communication Independence Limited receives the regulated activity, personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The last inspection of Communication Independence Limited was on 12 May 2015 and the service’s overall rating was good, with no breaches in regulations.

This inspection was undertaken on 9 and 12 January 2018 and was announced. We gave the service 48 hours’ notice of the inspection site and office visits because the service is small and we wanted to ensure the nominated individual or the registered manager would be available. We also wanted to arrange to visit some people using the service in their own home.

A registered manager and nominated individual were in place. 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. A nominated individual is a person nominated by the registered provider responsible for supervising the management of the service. The registered manager and nominated individual were equal partners in the service. The nominated individual and registered manager were present throughout our visit to the service’s office base.

There were sufficient support staff to meet people’s needs.

We found the service’s recruitment process required improvement to ensure that information and documents were obtained in accordance with the regulations to demonstrate staff were suitable to work with vulnerable adults.

A quality assurance system was in place to ensure that the quality of the service was continually assessed and monitored. This would be more effective by acting on improvements identified quicker.

Safeguarding procedures were robust and staff understood how to safeguard people they supported.

Support staff were provided with relevant training to help them maintain and develop their knowledge in regard to their role and received regular supervision.

Systems to control the spread of infection were in place.

There was an assessment of people’s needs, which contained information about people’s preferences, backgrounds and interests. This information had been used to develop a plan of care to inform staff of the care and support to be delivered. Care files included an assessment of the risks presented in caring for people and what action was required by staff to minimise those risks.

People were supported to eat and drink in accordance with their assessed needs and plan of care.

When needed, staff supported people to attend healthcare appointments and liaised with GPs and other health and social care professionals. Appointments were recorded and people’s support plans were updated with any changes arising from these visits.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered manager, nominated individual and support staff demonstrated that they were knowledgeable about the Mental Capacity Act (2005) and their role in ensuring people were involved in decisions about their care and treatment.

We observed staff and the registered manager interacting with people in a caring, understanding a

This inspection was undertaken on 12 May 2015 and was the first inspection of this service.

Communication Independence is a specialist domiciliary care agency registered to provide personal care. The service supports people who are Deaf, deafblind and/or visually impaired and who may also have other support needs, such as physical disabilities, learning difficulties and/or needs relating to their mental health.

Staff support people using a range of different communication methods. These include: British Sign Language (BSL), sign supported English (a form of sign language which uses the same signs as BSL in the same order as spoke English and is often used to support spoken English), Makaton (a communication system which uses signs and symbols often used to support the communication needs of people with learning difficulties) and deafblind manual (a method of spelling out words onto a deafblind person's hand).

Communication Independence registered with the Care Quality Commission in March 2014 and began to provide personal care to people in October 2014. The service were supporting two people at the time of our inspection.

There was a registered manager and nominated individual in post at the service. 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. A nominated individual is the person responsible for supervising the management of the service. The registered manager and nominated individual were equal partners in the service. The nominated individual was present throughout our visit to the service’s office base.

Communication Independence were committed to ensuring that people were safe and protected from harm. Support workers, the nominated individual and the registered manager were knowledgeable about safeguarding and ensured that people were aware of the differing ways they could alert key agencies should they have concerns about their safety.

There were enough support workers to meet people’s needs and an effective process was in place to ensure that employees were of good character and held the necessary checks and qualifications. Support workers received regular supervision and were provided with a range of training to help them maintain and develop their knowledge.

Our conversations with the registered manager, nominated individual and two support workers demonstrated that they were knowledgeable about the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) and when and where they would seek further advice in relation to both frameworks. The MCA promotes and safeguards decision–making. The DoLS are part of the MCA and aim to ensure that people are supported in a way which does not inappropriately restrict their freedom.

When needed, support workers assisted people to attend healthcare appointments and liaised with GPs and other health and social care professionals. Appointments were recorded and people’s support plans were updated with any changes arising from these visits.

We observed staff and the nominated individual interacting with people in a caring, understanding and professional manner. Our conversation with the person visited as part of our inspection, together with our conversations with support workers demonstrated that the service had a clear knowledge of the importance of dignity and respect and were able to put this into practice when supporting people.

Communication Independence were committed to ensuring that people with sensory impairments received information in appropriate formats and were able to access equipment, independent interpreters and advocates in order to ensure that information was appropriately presented and explained.

The person visited during our inspection told us that they were involved in the writing of their support plan and were provided with opportunities to express their views about the service. Support plans were centred on people’s individual needs and contained information about their preferences, backgrounds and interests.

Support workers were positive about the registered manager and nominated individual and the way in which they led the service. They told us that both individuals were supportive and listened to suggestions and ideas about how to improve the service. A range of audits were in place and were being developed to monitor the quality of the service.