Longworth CMS Ltd

Longworth CMS Ltd provides personal care services to one person with a learning disability and autism who lives in their own home. This limited company was set up by the person's parents to arrange and direct the care for the person. The limited company employed the person's family members and non-family members to provide the care.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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.

This was the first inspection of this service since it was registered.

Staff understood their roles and responsibilities to safeguard the person from the risk of harm and risks to the person were assessed and monitored regularly.

Staffing levels ensured that the person's care and support needs were met safely and safe recruitment processes were in place. The person was supported by a small and consistent staff team that meant that they could develop positive relationships with staff that understood their needs.

The providers had followed legal requirements to make sure that any decisions made or restrictions to the person were done in the person's best interest. The providers were well aware of the Mental Capacity Act (MCA) 2005.

The person's needs and choices were assessed and their care was provided in line with up to date guidance. Care plans contained personalised information about what was important to the person, what mattered to them, what they would like the staff team to know and do, and the help and support they needed.

The person received care from staff that had received training and support to carry out their roles. For example, staff received training and support to use a picture exchange communication system (PECS) to meet the person's individual needs. Staff told us they were very happy with how they were supported to carry out their role. One staff member described the support they received as 'brilliant'.

Risks were assessed and recorded by staff and there were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned if things went wrong.

Staff understood how to support the person to manage behaviours that the service may find challenging. There were positive behaviour support plans in place.

The service worked with healthcare professionals to ensure that the person's needs were met. Recommendations from healthcare professionals were incorporated in the person's care plan.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines were suitable for the person who used the service.

Staff were caring and the person was at the centre of the care provided. The service focused on person centred outcomes and recruited staff who had the right values. The staff worked with the person to focus on what was important to them and to support them to achieve the most out of their lives. The person benefited from the extremely committed staff who delivered effective care and support. There were many examples of staff working together to achieve a very positive impact on the person's daily life.

Staff treated the person with dignity and respect and ensured their privacy was maintained. Staff spoke about 'working for the person' that was receiving the service and spoke respectfully about how they always responded to the person's non-verbal and verbal communication. One member of staff told us, "[The person] teaches us things each day. [The person] is brilliant".

The person was not able to communicate their wishes verbally and staff supported them to communicate their wishes each day using a picture exchange communication system (PECS). One member of staff told us, "We use the PECS system each day and I am also trying to support [the person] to use their voice". We observed how the PECS system was used by the person and how their wishes and communication was responded to.

The person benefited from support by staff to engage in a wide range of activities and interests. This included accessing activities in the community they enjoyed such as horse riding, a bike club for adults with a disability and going to places of interest. This had provided opportunities for the person to live their life to the full each day and reduce any feelings of frustration and distress.

Staff were encouraged to provide feedback about the service and it was used to drive improvement. One member of staff told us, "Communication is great. I can raise anything with [the registered manager]".

The provider had daily contact with staff to identify any changes in need or to identify any approaches to improve daily outcomes for the person. The provider had systems in place to monitor the service provided and any areas identified as needing improvement were actioned immediately. One health care professional told us the provider worked hard and planned well to meet the person's needs.

The five questions we ask about services and what we found