Blossoming Care Ltd

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people received respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The service had only recently started providing regulated care and therefore some systems and processes were still developing. People and relatives were generally positive about their care and described staff as kind, patient and respectful. Care was personalised around people’s needs, routines, communication and preferences, with staff promoting independence, choice and least restrictive practice.

Care plans identified known triggers, possible functions of behaviour and proactive strategies staff could use to reduce anxiety and distress. Staff understood that behaviour could be a form of communication and adapted their approach to understand and respond to people’s underlying needs. Care planning reflected a least restrictive approach, promoting independence, choice and control while managing identified risks. Staff used preventative and de-escalation strategies and described remaining calm, reducing demands and adapting their approach when people became anxious or distressed.

Leaders were receptive to feedback and open when evaluating where changes were needed and how best these should be implemented. For example, they had been responsive to incidents and worked with people, families and staff to improve care planning guidance and staff working practices. Senior staff had a good understanding of people’s needs and maintained regular contact with people, relatives and staff. This helped them oversee the quality and safety of the service.

Care plans reflected people’s preferences, routines and what was important to them. They included goals around making choices, developing everyday skills and increasing community access. Staff encouraged people to participate in their care, make choices and do as much as possible for themselves. People’s individual communication needs were documented, including how they communicated through body language, gestures, behaviour and other non-verbal cues. Staff understood these approaches and adapted their communication to help people express their wishes and make choices.

The provider was using agency staff to deliver care while recruiting its own permanent workforce. Systems were in place to complete due diligence on agency recruitment and training, monitor staff practice and provide induction and ongoing support. People had small staff teams allocated to their care to promote continuity, and relatives reported receiving consistent care from regular staff without missed or late visits.

The provider planned to expand its services across 4 local authority areas, although regulated care was only being provided in one area at the time of our inspection. The service operated from the registered location in Southampton. Leaders recognised that expansion across different geographical areas would require appropriate local infrastructure and were considering satellite offices to support this, including in the Northamptonshire area, where they were currently providing regulated care. The provider was also developing business continuity plans to better reflect local arrangements. These developments would help maintain safe and consistent care as the service expanded.

The registered manager had recently left the service. In their absence, the nominated individual and co-ordinators were overseeing the day-to-day running of the service. The nominated individual had identified a prospective replacement, who had begun the process of applying to CQC to become the registered manager. Staff were positive about the support they received from senior staff and described leaders as accessible and responsive. They told us they had the information and support they needed to carry out their roles effectively.

The provider demonstrated a positive and responsive approach to learning and improvement. Systems had been established to monitor care delivery, staff training, care records, incidents and people’s changing needs. However, as the service was relatively new, there had been limited opportunity to demonstrate how effectively these governance arrangements operated over time, particularly as the service expanded. The provider had identified areas where systems and processes could be further developed, including partnership working, longer-term outcomes for people and completing outstanding information within care plans.