Active Care Group Supported Services

Active Care Group Supported Services provides support for autistic people, people with learning disabilities, physical disabilities or mental health needs. People's care and housing are provided under separate contractual agreements, although we have highlighted within this report that the separation between these two elements had not been made clear to people. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

At the time of this inspection, the service was providing support within the regulated activity of personal care to 36 people across six ‘supported living’ settings. The settings included accommodation in both small shared houses and larger blocks of flats.

People’s experience of using this service and what we found

People were not always supported to have maximum choice and control of their lives and despite staff having a good understanding of people’s capacity, support was not always delivered in the least restrictive way possible and in their best interests; the policies and systems in the service did not consistently support best practice.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

The quality of support that people received across the different settings was not consistent. At one setting, people did not always receive the care they needed to live safe, happy and fulfilling lives.

There were not always enough staff on duty. In addition to staffing shortages, some of the settings relied on high levels of temporary staff who did not always have the skills and experience to meet people’s needs and expectations. Recruitment processes were safe, and the provider was taking active steps to increase number of staff and ensure that staff were deployed effectively.

Staffing issues had a significant impact on the way people received their care. People and their families told us that staff did not always have the time to provide support in a way that increased people’s skills and promoted their independence.

There were systems in place to support people with their healthcare needs, and managers were working hard to build more positive working relationships with other professionals to ensure people received the care they needed.

Right Care:

People did not consistently receive care that was person-centred. Whilst staff understood the importance of individualised support, the challenges with having enough experienced staff meant that often they had to prioritise the needs of the group, rather than the individual.

People at one setting told us that some staff had not treated them with respect or kindness. Where those individuals were able to be identified, immediate action was taken to ensure people were safeguarded. Other staff were praised for their commitment and dedication to doing the right thing.

Right Culture:

The culture varied across the settings. At one setting, people did not feel listened to or valued. They told us they had given up raising complaints because nothing ever changed. At other settings, despite the staffing challenges, people felt engaged and informed about what was going on. This led to the feeling a greater sense of control over their lives.

The new registered manager and senior leadership team were working hard to change the culture across all settings, they were already aware of many of the issues people raised with us and were working hard to implement the changes that were needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection This service was registered with us on 11 November 2021 and this is the first inspection.

The last rating for the service under the previous provider was Good published on 27 November 2020.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the safety of people’s support. As the service had not previously been inspected under the new provider a decision was made for us to carry out a full inspection to provide a rating.

We found evidence the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

The provider fully engaged with the inspection process and has already provided evidence of immediate action that has been taken to mitigate the risks identified.

Enforcement

We have identified breaches in relation to person-centred care, safeguarding, the safety of medicines, management of risks, staffing and good governance. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.