About the service

Complete Care and Enablement provides supported living and domiciliary care. The service is also known as CareTech by some of the people who used the service and their relatives. At the time of this inspection, 13 people were in receipt of personal care. The majority of people who used the service lived with a learning disability and/or complex mental health needs and were aged under 65.

People’s experience of using this service

¿ The service was exceptionally responsive to people’s needs. People's confidence and independence had increased since they started to receive support from Complete Care and Enablement. People were encouraged to live full and active lives and were empowered to participate in value based activities. The service's ethos was to fulfil people’s aspirations and support them to achieve their goals. Activities were meaningful and reflected people’s interests and personal preferences.

¿ People had comprehensive risk assessments in place and support plans that were focused on empowering people to achieve their goals and ambitions. People's support plans were tailored to them and had been developed with involvement of their families.

¿ Staff benefitted from specialist training and people were working with behaviour specialist’s and psychology to complete work which was outcome focussed and aligned with a supported person's life journey.

¿ People received multidisciplinary input from a range of professionals which included, physiotherapy, occupational therapy, psychiatry and psychology.

¿ The registered manager was inspirational and led by example. They followed best practice and pursued opportunities to improve care and people’s experiences to attain better outcomes. There was an open, honest, caring and positive culture across the service and staff demonstrated a high value base. This was clearly led from the top down. The registered manager was also supported by a team of exceptionally motivated and dedicated service managers and team leaders.

¿ Staff consistently demonstrated the values of the service and put people at the heart of everything they did. Staff were clear they worked as a team and for the benefit of everyone who used the service. Staff provided enthusiastic and individualised support to people which was prioritised over daily tasks such as household chores and tidying. People and their relatives spoke highly of the support people received and attributed their progress and quality of life to the staff and support they provided. People were motivated to achieve and their accomplishments were celebrated.

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

Rating at last inspection: Good (Report published 15 September 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved its overall rating to ‘Outstanding.’

Follow up: We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated outstanding.

We inspected Complete Care and Enablement Services on 11 and 12 April 2016. The service is also known as CareTech by some of the people who use the service and their relatives. As this was a supported living and domiciliary care agency service, we contacted the service manager (in the registered manager’s absence) one working day before the inspection. This was so that they could let the people who lived there know we were coming. At the last inspection in October 2013 we found the service met all the regulations we looked at.

At the time of our inspection, the service was supporting 14 people in five ‘supported living’ properties. Supported living describes the arrangement whereby people are supported to live independently with their own tenancies.

The properties were located in Tameside and Trafford and the service was in the process of setting up three new properties to support a further seven people in their own tenancies. In addition to supported living, the service also provided domiciliary care for five people in their own homes.

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.

People using the service told us they felt safe and the relatives we spoke with also agreed people were safe. Support workers could explain the various forms of abuse people might be vulnerable to and said they would report any concerns appropriately.

Staff rotas were based upon the number of hours of support people had been assessed as needing. People, their relatives and support workers told us they thought there were enough staff to meet people’s needs.

We saw that facilities and equipment in the properties we visited had been checked and were safe. Comprehensive risk assessments were in place and people were supported with positive risk-taking.

People’s medicines were managed, administered and documented correctly by support workers and we saw that people received their medicines in a person-centred way.

We saw that people’s flats and shared communal areas were clean and tidy. People told us they were supported by staff to do their own cleaning tasks.

Support workers understood how the Mental Health Act (1983) and Mental Capacity Act (2005) affected the people they supported. The registered manager was working with the relevant local authorities to ensure that any deprivation of people’s liberties was done so lawfully.

Support workers received the training and support they needed to care for the people safely and effectively. The service had implemented the Care Certificate, an induction programme for support workers new to care.

People who needed assistance to shop for and cook food were supported to do so by staff. Staff encouraged the people to eat healthy foods but respected people’s meal choices.

We saw that the people were supported by staff to maintain their holistic health by visiting healthcare professionals such as their GPs, dentists and opticians.

It was clear that staff knew people well as individuals and we saw people and staff interacting in a warm and friendly way.

Support workers could give examples of how they promoted people’s independence and respected their privacy and dignity. People told us that staff supported them with domestic tasks, such as cleaning, shopping and cooking.

We saw that people’s support plans were person-centred and based upon their likes, dislikes and preferences. Care files contained information about how people liked to be supported in all aspects of their care and we saw that support plans were reviewed regularly.

People told us and daily records showed that people were supported by staff according to their support plans.

People told us that they had enough to d

On the day of our visit the service had six people receiving support in their properties and three people supported in the community. We saw three care files which included appropriate signed documentation. We spoke with four members of staff who gave examples of different methods of communication used to ensure consent was obtained.

The care files contained relevant health and personal information. Reviews were not all up to date, but the service was in the process of making changes to documentation and we saw some of the completed files. We were told that records would be brought up to date over the next two weeks.

We spoke with two people who used the service and one relative. One person told us, “They ask what I want when they write my care plan”. Another said, “I am involved in everything”. The relative commented, “Staff are brilliant with X. There’s nothing they can’t cope with”.

The service had relevant and up to date policies including safeguarding. We spoke with four staff members who all demonstrated an understanding of safeguarding issues and were aware of the processes to follow.

The staff members felt that they were well supported by the company. There was a comprehensive induction procedure and supervisions took place regularly.

There was a complaints procedure and complaints were followed appropriately. Various audits were undertaken and service user and staff satisfaction surveys, analysed the results and addressed any issues raised.