United Response – Bradford Community Support provides care and support to people with learning disabilities across the Bradford district. The main objectives are to support people to make meaningful relationships and networks in their local communities and have fulfilling daytime opportunities. Support is delivered in a flexible way to meet the needs of each individual. Most support is offered out and about although some support may be in the person’s own home or at a community base. The inspection took place between 21 and 27 July 2017 and was announced. This meant we gave the provider a short amount of notice of our visit to ensure a manager would be present to assist us. At the time of the inspection 27 people were using the service, with 16 of these people receiving support with personal care.

There was a registered manager in post. 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 the last comprehensive inspection in November 2015, the service was rated ‘requires improvement’ overall, with two breaches of regulation found relating to ‘Safe care and treatment’ and ‘Good governance.’ We found improvements had been made to care plan documentation and as a result the service was no longer in breach of these regulations.

Overall, we rated the service as ‘Good.’ People, relatives and staff spoke highly about the organisation and said they would recommend. We saw overall, people received high quality care that met individual needs. The management team were responsive to people’s concerns and complaints and took them seriously. Staff treated people with kindness and compassion. We found the registered manager was open and honest with us and we felt assured that any areas for improvement that we identified would be promptly addressed.

At this inspection we found some improvements were needed to the safe domain. People and staff raised some concerns over the reliability and consistency of staff and high staff turnover. Whilst people said personal protective equipment (PPE) was worn by staff, staff said there was sometimes a lack of availability aspeople or their relatives were responsible for providing this rather than the service. Overall medicines were safely managed, although some medicine profiles required more detail as to the exact nature of the care and support provided.

People said they felt safe and secure in the company of staff. Detailed risk assessments were in place which provided staff with clear information on how to keep people safe. Staff we spoke with had a good understanding of people and how to keep them safe. Incidents and accidents were recorded and action taken to learn from adverse events.

Staff received a range of training and support relevant to their role caring for people with learning disabilities. A person who used the service had delivered training to people which made staff appreciate things through their eyes and was a creative approach to training provision. People received care from a consistent team of staff who knew people and their needs well. Safe recruitment procedures were in place to ensure staff were suitable to work with vulnerable people.

The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s capacity to make decisions was assessed and where people lacked capacity, best interest processes were followed. People were involved in decision making to the maximum extent possible and people had control and choice over their daily lives.

Staff treated people with a high level of dignity and respect. People spoke positively about staff and gave positive examples of how they had helped and supported them. Reg

This inspection took place between 5th and 20th November 2015 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be available to support us.

Community Support provides care and support to people with learning disabilities across the Bradford district. The main objectives are to support people to make meaningful relationships and networks in their local communities and have fulfilling daytime opportunities. Support is delivered in a flexible way to meet the needs of each individual. Most support is offered out and about although some support may be in the person’s own home or at a community base. Some people lived in a supported living house with other tenants.

There was a registered manager in post. 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 who used the service were positive about the service they experienced. They told us they felt safe with the staff that supported them. One relative shared a concern in relation to an incident but told us this was quickly resolved.

Staff had received training in protecting people from harm and knew what action to take if they had any concerns about potential abuse. Risk assessments were carried out so that risks to people were minimised while still supporting people to remain independent. We found some identified risk had not been assessed.

People told us there were sufficient numbers of staff available to provide them or their relatives with the support they needed at a time that suited them. We were told support staff usually arrived on time and stayed the agreed time.

People were supported with the management of their medicines and their health and dietary needs to support their well-being. People had individualised dietary plans to suit them.

Staff told us they received training that gave them the skills and knowledge they needed to support people effectively. They said they were well supported in their work and had regular meetings with their line manager and team meetings.

Staff knew how to support people’s rights and shared examples of how they respected people's choices, dignity and independence. People and their relatives told us people were encouraged to do things for themselves.

People’s needs were assessed and plans were in place to meet their needs. Not all of the plans we viewed were complete.

People told us they were involved in their person centred reviews and discussions about their care requirements. They said they felt listened to by the staff and managers and knew who to speak with if they had any concerns.

People described staff as kind and friendly and said they were treated with respect. People had developed positive relationships with their support workers and the management team.

People who used the service and staff told us they found managers open and approachable and considered the service was well-led. Relatives shared mixed views about how well led the service was.

Staff had a clear understanding of people’s needs and built up professional relationships with people. The rota was created to try match people with their preferred staff members.

We saw there were systems in place to gain people’s views and monitor the quality of the service people received.

People told us and we saw documented evidence people were support to go out on a regular basis. People had meetings to identify what they wanted to do and then action plans were put into place to meet people’s goals.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the

When we visited one of the bases where shared support was delivered we saw three members of staff supporting service users. We saw interactions between staff and the people who used the service which were very positive. It was clear the managers were often in the base as the people who used the service interacted with them also. We saw people being asked what they wanted to do. We saw equipment such as glue, scissors and paints were kept locked away apart from when they were being used under supervision. We saw each person was supported in a different manner for example one person liked a quiet approach and another wanted interaction. It was clear the staff were well aware of the needs of each person.

We saw a copy of an easy read leaflet for people who used the service. It explained what abuse is, who might be an abuser, their rights and how to get support. Staff were well supported through training and regular peer and management support.

The provider monitored the quality of the service through a number of systems providing different perspectives on the quality of the service.

We spoke one person who used the service and with six relatives of people who used the service. Out of the seven people we spoke with, six of them said they were completely satisfied with the care received. Their comments included:

“I am really happy with them.”

“All staff are excellent, they understand him and his needs, he is very well cared for."

“Brilliant, no faults at all.”

“Great service, they help me every day with my life.”

One relative told us they were unhappy with the standard of care received as they thought a reduction in resources such as transport and activities and a lack of experienced staff had caused a decline in the standard of care.

We found people were treated with dignity and respect and people and/or their relatives were involved in decisions in relation to their care.

We found people’s needs were fully assessed so that appropriate care was planned and delivered.

Staff told us they were well supported and received appropriate training. Robust recruitment procedures were in place and a range of training was on offer to staff.

Systems were in place to seek the views of people who used the service and ensure the quality of the service was regularly assessed.