Moore Care and Support

Moore Care and Support provide individual supported living services for four people with a learning disability, a significant complex mental health need and who require one to one support at all times, Both within the community and their home environment.

At the last inspection in July 2015 the service was rated overall good and outstanding in the key question of Well Led. At this inspection we found the service remained good and had demonstrated that it remained outstanding in well led.

The registered manager was also the provider. 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.

The registered manager promoted a strong person centred ethos, which was evident throughout all branches of the service. The registered manager had an experienced background in working with people with very complex needs. They had enriched the skills and knowledge of senior staff by providing them with specialist training and learning opportunities related to people's needs and backgrounds.

The registered manager was a strong presence in the day to day running of the service. They had an intimate knowledge of people's needs, staff's strengths and the day to day challenges they faced. The registered manager and management team were constantly available to people and staff to offer guidance and support and would attend to any serious incidents that took place.

The provider had a consistent record of highly effective collaborative working with other stakeholders to promote people's health and wellbeing. We received very positive feedback from social workers and health professionals which underpinned how effective these partnerships were. The provider had fostered effective relationships with people, many of whom had experienced a history of breakdown in their care and accommodation placements due to their complex needs.

The provider fostered a culture where people were encouraged to reflect on their behaviours and associated risks. Staff helped enable people to recognise the triggers for their behaviours, the consequences and develop ways in which to manage these risks independently. The provider ran a therapeutic group where people and staff could talk openly about their successes, challenges and anxieties, which provided a forum in which strategies to promote positive behaviour could be implemented.

People were actively encouraged to plan and review their care. Staff were driven to enable people to be as independent as possible. People were supported to unlock their potential by identifying their aspirations and setting realistic goals to help them work towards them. Staff were focussed on providing people with opportunities to learn new skills, challenge themselves in various settings, empowering them to take responsibility over their behaviour.

People were encouraged to utilise their skills to benefit other people, contributing to society in a meaningful way. The provider had supported people to use their knowledge and experiences to provide support to other people in similar circumstances.

The provider had worked with people to provide innovate opportunities to give feedback to health and social care professionals. People were encouraged to talk about their feelings and discuss when they were not happy. The provider handled complaints openly and ensured that people were happy with the outcome of investigations when concerns were raised.

Staff received training which was relevant to their role. Where people had specific medical or behavioural needs, the provider sourced additional training in these areas. The registered manager monitored and assessed staff's working practice, encouraged staff to reflect on their working practice in order to make improvements.

The registered manager had recruited suitable numbers of qualified and skilled staff. They conducted a 'values based interview', which helped them to identify staff that had the appropriate behaviours and attitudes to work with people. People were involved in selecting their own staff and the registered manager carried out appropriate pre- employment checks in order to further establish candidate's suitability.

There were systems in place to protect people from abuse and harm. Staff had all received training to help them identify abuse and actions to take to protect people. The provider had also worked with people to help them understand what constituted abuse and who they go to for support in these circumstances.

People were supported 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 support this practice.

People received personalised care and were treated with dignity and respect. People were involved in developing their care plans to identify their preferences, routines and how staff could provide effective support. Where people required support with eating and drinking, any dietary requirements were taken into account and care plans were developed to ensure that these requirements were met.

The registered manager assessed people's needs in collaboration with people, families and health professionals. When incidents took place, the provider took appropriate advice and guidance from professionals to help ensure their plan of care was proportionate to associated risks and reflective of people's choice.

People were supported to take their medicines as prescribed. The level of independence around their medicines management was identified in their care plans. People were supported to review their medicines with doctors on a regular basis to ensure their prescribed medicines were suitable for their needs. People had access to healthcare services when required and the provider supported people to have their healthcare needs regularly reviewed.

Risks associated with the spread of infection were assessed and monitored. The provider had policies in

place to help ensure staff understood their responsibilities around infection control.

The provider had conversations with people around end of life care and staff had accessed training to support people with bereavement when they lost their loved ones.

The five questions we ask about services and what we found