Exclusive Therapies Limited

Mayflower Gateway Business Centre provides support for people with a range of needs including those living with dementia, people with learning disabilities or autistic spectrum disorder, mental health and older people. Where the care service supports those with learning disabilities or autism it 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 life as any other citizen.

The amount of time for care visits ranged from 15 minutes to 12 hours. When we inspected, 44 people were receiving care. Not everyone who used the service received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The inspection took place on 16 and 19 July 2018 and was announced on both days. The provider was given notice because the location provides domiciliary care services and we needed to be sure someone would be available to assist with providing information for the inspection. We contacted people who used the service and their relatives on 17 July 2018 to ascertain their views.

The service registered with CQC on 1 August 2017. This was its first inspection.

The service had a registered manager in place, who was also the nominated individual and registered provider. They were present throughout the inspection. A registered manager is a person who has registered with CQC 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 had not submitted a Provider Information Return (PIR) to detail what the service was doing well and any improvements they planned to make. This was completed following the inspection site visits. Not sending the PIR when this was requested limits the rating for well-led.

A log of significant events that happened in the service to ensure these were addressed consistently and to review any changes needed as a result had not been kept. The registered manager agreed to keep a record with these details. Audits were not being completed to identify and analyse trends across the service and

show how improvements were made. We have made a recommendation about quality assurance.

Staff worked with families, involving them in people's medication arrangements. Information was shared amongst staff, the person's GP and family to ensure all parties had up to date details and were supporting people safely and effectively. The registered manager undertook to introduce protocols for 'when required medicines'.

An electronic alert system informed the registered manager and deputy manager when key information had not been recorded following care visits for hydration, medicines or security. Alerts were checked to enable any action to be taken. This helped keep people safe.

The registered manager provided us with a health questionnaire on the second day of inspection and had made arrangements for staff to complete these.

Consent was understood by staff. We saw consent forms completed for people that had capacity to agree to their care arrangements. Where documentation had not been completed for one person who lacked capacity the registered manager agreed to action this.

There were sufficient staff to meet people's needs and people received care at their preferred times. Changes were made to people's care visit times to fit with their appointments and family arrangements. People's care took into account their communication needs and how they wanted to be treated with dignity and respect. Care plans contained detailed information about people's care needs and how to support them. Step-by-step instructions helped ensure a consistent approach to more complex care interventions. Staff were sensitive and respectful towards people and their properties. End of life care was recognised as requiring a unique, respectful approach.

Staff received training to equip them for their role. Some staff had 'champion roles' where they had completed additional training or experience in specific aspects of care.

The service was trusted and valued by people and their relatives. We received consistently positive feedback. There was mutual respect between staff and the registered manager. This helped ensure a motivated, high performing workforce.

The five questions we ask about services and what we found