Background to this inspection
Updated
21 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
3 Inspectors and 1 assistant inspector carried out the inspection.
Service and service type
This service provides care and support to people living in 25 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we wanted to be sure there would be people at the office to speak with us.
Inspection activity started on 21 March 2023 and ended on 18 April 2023. We visited the location’s office on the 21 March and 23 March and visited people in their supported living settings on the 28 March 2023.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authorities who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. All of this information was used to help us to plan our inspection.
During the inspection
We visited 2 locations and spoke with 5 people. We carried out a video call with 1 person. We carried out phone calls to 6 relatives about their experience of care. We spoke with 14 staff members including the nominated individual, registered manager, locality managers, managers, care staff and the training officer. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We carried out observations of people’s care.
We reviewed 6 care plans and records relating to monitoring of people’s care needs. We reviewed 4 staff members files to review the recruitment processes in place. We viewed records relating to training and how the quality of the service was monitored.
Updated
21 June 2023
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.
About the service
Select Lifestyles Limited is a supported living service providing personal care to people with learning disabilities and autistic people living in their own homes. People are supported over 25 different properties with some people living in self contained flats and others living in shared accommodation. Not everyone who used the service received personal care.
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 the inspection there were 67 people receiving personal care.
People’s experience of using this service and what we found
Right Support:
People had not always had all of the risks associated with their care assessed, monitored or mitigated. Some people’s care plans needed further information about how to reduce risks in their care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not always provide evidence that this practice had been carried out with recorded documentation.
Staff supported people to take part in activities and pursue their interests in their local area. Staff enabled people to access specialist health and social care support in the community and people were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Right Culture:
Systems to oversee the quality of the service had not always been effective. We identified that learning from incidents and analysis of trends and themes had not always taken place.
Staff evaluated the quality of support provided to people. However, people had not always been involved in these reviews.
The service enabled people and those important to them to work with staff to develop the service. However, systems were not in place to demonstrate how this feedback had been acted on or reviewed for the effectiveness of the action taken.
The registered manager was quick to respond to the concerns identified on inspection. However, systems needed improving to ensure concerns were identified to enable a culture of continuous improvement.
Staff placed people’s wishes, needs and rights at the heart of everything they did.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service had moved address since our last inspection. The last rating for this service under the previous registered address was requires improvement (Published October 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service, and in part due to concerns received following a local authority quality visit to the service. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well Led sections of this report.
Enforcement
We have identified breaches in relation to how people were supported safely and in the governance systems at the service.
Please see the action we have told the provider to take at the end of this report.
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.