The inspection took place on 13 and 16 January 2017 and was announced to make sure there was someone available at the provider’s offices. We last inspected this service January 2014 and found that the provider was meeting the legal requirements in the areas we looked at.

Headway East Sussex Ltd provides services commissioned by local authorities, or on a private basis to people who have an acquired brain injury. Registered as an outreach service it supports people in their own homes or local community. Support workers work with individuals to assist them to relearn basic skills they may have lost, help them with appointments, build their self-confidence and to enable them to take advantage of local facilities.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had individualised risk assessments that gave guidance to staff on keeping them safe whilst supporting them in regaining their confidence and re-learning their daily life skills. People’s safety was protected because staff were trained in safeguarding and knew how to keep people safe from avoidable harm. There was enough staff to safely meet people’s needs and staff had received appropriate training to support their role. The provider had policies and procedures in place for the recruitment of new staff.

People were able to express their views and be actively involved in making decisions about their care. Staff were knowledgeable about people’s care needs and received specific training to meet these needs. They sought people’s consent before providing care, and they understood the requirements of the Mental Capacity Act 2005. Staff demonstrated empathy and were caring and respectful whilst discussing their role with us about the people they supported. They also showed us that they were respectful of people’s dignity and privacy. People’s needs had been identified prior to them starting to use the service, and were reviewed regularly. People were supported in a personalised way and they all had individualised support plans in place.

Staff said the management was fair and approachable, staff meetings were regular, to discuss people's needs and discuss any changes to the organisation or the way they worked. Staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the manager was always available and, they would be happy to talk to them if they had any concerns. Staff were supported in their role and to take part in the development of the service. Regular audits and surveys were carried out to monitor and manage the quality of the service.

We spoke with seven people who used the service, four in person and three by telephone. We also spoke with the chief executive, the registered manager and three care workers. We looked at care files and policy documents to help us understand how the service was delivered.

Managers and care staff were aware of their responsibilities under the Mental Capacity Act. People signed their support plans and other documents to show their consent. Care workers gained consent on a day to day basis. One person said, “They ask what I need to do; we plan what I want to do. I’ve never done anything I didn’t want to.”

We found that people’s care needs and risks were assessed and care and support planned and delivered to meet those needs. People reported good outcomes. One person told us, “I had problems getting into conversation with people and that’s improved. I’m improving in general and that’s making me feel more confident. My family think it’s helping me.” Another simply said the service was, “Brilliant!”

People felt safe using the service and care staff knew how to recognise and report abuse. One person said, “I would contact Headway head office, or East Sussex Social Services.”

There were adequate arrangements and systems to prevent the spread of infection.

There was a complaints system. People knew how to raise a concern and felt confident that their issue would be heard and dealt with.

During the inspection and subsequently we spoke with five people who used the service. We also spoke with the manager and four members of staff.

All people using the service had an acquired brain injury which is an injury which had occurred since birth. Some people for example had had a brain tumour, an accident or had been attacked. The outreach service Headway had provided support to these people to help them relearn and cope with day to day living.

People told us that they were satisfied with the care and support they received from Headway. People told us that they had been involved and consulted in the way care was given and reviewed. People were supported to maintain their independence and work towards achievable goals. People we spoke with said that the staff were very supportive, one said, ”they have made such a difference to my life, I can’t believe how far I have come in the last year”.

We viewed support plans, they gave clear guidance to staff on their role in meeting people's support needs. This was done in a way that reflected people's individuality and preferences.

People were protected from the risk of abuse because staff were trained to recognise and report any concerns.

There was a robust recruitment procedure at the agency to make sure new staff were suitable. There was also support for the staff by way of training and ongoing supervision.

The agency had systems in place to measure the quality of the service they provide.