The Rathbone Centre provides support, including personal care, to people with learning disabilities through domiciliary care and supported living services.

Not everyone using the services of The Rathbone Centre receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’. Where they do we also take into account any wider social care provided. There were approximately 70 people using the service at the time of inspection but only a small number were receiving support with ‘personal care’.

The visits were announced and were carried out on 13 August and 4 October 2018. The provider was given notice because the location provides a domiciliary care and supported living service. We needed to be sure that someone would be in at the location office when we visited and we then arranged to go back to meet with people at the Rathbone Centre drop-in service to get their feedback.

The registered manager was about to leave the employment of the service and an acting service manager was in post who was in the process of registering with CQC. 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.

At our last inspection in January 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were positive about the care and support provided by The Rathbone Centre. They told us they felt safe and that staff treated them with dignity and respect. They were happy with the support provided which was meeting their individual needs.

Training on the safeguarding of adults had been completed and the staff were aware of their responsibilities for keeping people safe from avoidable harm or abuse. Each person‘s needs had been assessed and any risks associated with their support were identified and monitored.

People were supported by staff who were trained and well supported in their job roles. Appropriate checks were carried out for people wishing to join the staff team. People using the service were involved in the recruitment process and new staff provided with an induction into the service.

People felt there were enough staff members suitably deployed to meet their current support needs. A new more flexible model of support had been introduced with support staff available at a drop-in centre for two days a week. Staff we spoke with were confident that they provided a good service.

Staff had received training in the management of medicines. People were supported to take their medicines as prescribed in a safe way.

People were able 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. People were supported to maintain their independence, follow their interests and take part in activities they enjoyed.

People knew what to do if they had a concern and felt confident to raise any issues with staff and managers at the Rathbone Centre.

We carried out this unannounced inspection on 13 and 19 January 2016.

The Rathbone Centre provides support, including personal care, to people with learning disabilities through domiciliary care and supported living services.

The service has a registered manager in post at the time of the 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.

People felt safe. The provider identified risks to people and had up to date plans to keep them safe from avoidable harm. Staff understood how to recognise signs of abuse and what they would do if they suspected it. The provider followed robust recruitment procedures to ensure that staff supporting people had the necessary skills, attitude, experience and background to safely do so.

People were asked for their consent to the care and support they received. The provider met the requirements of the Mental Capacity Act 2005. Staff knowledge and skills were subject to on going evaluation and improvement through supervision and training. People’s nutritional needs were met and the service supported people to access health and social care services.

Staff were caring and respectful towards people and their homes. People’s dignity was maintained and choice was promoted. The service supported people to access advocacy services to make choices.

People were supported to participate in a range of activities they choose. The provider established a number of groups and held a number of events to prevent social isolation. People’s care plans detailed how they would like their needs met and people were supported to pursue their interests and hobbies.

The provider sought feedback from people, relatives and staff and acted upon it to improve the quality of care and support people received.

Staff spoke highly about the registered manager and said he was approachable and supportive.

Health and social care professionals were complimentary about the care and support people received from the provider and praised the management of the service.

The registered manager had effective quality monitoring systems in place to ensure the quality of service provision was maintained and improved.

People using the service experienced care that was planned and scheduled to meet their needs and mitigate any risks. Care was reviewed on a regular basis and could be modified when required. Records showed that the care delivered reflected the current care plan.

The provider had suitable procedures to manage emergencies and staff had the necessary training to do so.

Care plans and reviews were signed by people using the service to indicate agreement to the care that they received, and staff were trained to ensure people’s consent.

The provider cooperated and liaised with other providers as appropriate and maintained relevant contacts and correspondence.

Staff had appropriate induction and training support. They received regular supervision and appraisals and felt well supported by management.

The provider had a variety of systems to monitor the quality of service provided and feedback from people using the service indicated a high level of satisfaction with the care they received. People were contacted regularly to obtain feedback on their care.

People we spoke with were happy with the care and support they experienced. One person using the service told us, "I’m happy, the staff are nice. I have a plan and I always know what I’m doing." The relative of another said, "They’re good at finding the right staff – I can’t fault them.”

People we spoke with felt that the service met their individual needs and preferences. Their support workers listened to them and took into account their choices, treated them with respect and maintained their privacy and dignity when providing support.

One person told us, "My support workers always discuss things with me and we work as a team.” Another said, "The support workers are a real godsend and I can’t do without their help".

People told us they were involved in the planning of their care. They had discussed their care with the provider when it first started and the provider had since reviewed their needs with them.

People we spoke with said that their support workers understood their needs and carried out their work competently. Those supported in their homes said their support workers turned up on time and they were informed if there was any delay. The support workers stayed for the allocated time.

People told us that they benefit from a service that is reliable, consistent and run in their best interests.

Individuals feel confident in the knowledge that their communication needs are acknowledged and responded to by skilled experienced support workers.

People find that they are kept fully informed of the identity of the support worker, and find that this reduces any anxiety about strangers coming to their home.

People experience good outcomes from the service delivered, they feel empowered, and enabled to lead ordinary and meaningful lives.

Care management professionals find that the service delivered is highly personalised, and that it is totally centred on the needs, wishes and views of the individual using it.