We carried out a review of the data available to us about East Cheshire Housing Consortium on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about East Cheshire Housing Consortium, you can give feedback on this service.
East Cheshire Housing Consortium is a community-based service providing support to 92 people at the time of the inspection. People receiving a service require varying levels of support as a result of ongoing mental health needs, ranging from 24-hour support in a supported living setting to domiciliary support. During the inspection we identified many people receiving support, also had a learning disability or were autistic.
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.
People’s experience of using this service and what we found
People were supported by staff who had received a detailed induction and suitable training to meet people’s needs. People receiving support spoke positively of the care and support they received and told us they were happy.
Systems were in place to manage risks to people’s health and wellbeing and medicines were managed safely.
The service was well-led. Staff felt well supported by an open and honest culture. The provider also worked effectively with other professionals and organisations to ensure positive outcomes were achieved for people. Robust systems had been introduced which ensured there was an improved level of oversight and monitoring of the quality of support being provided to people.
People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were supported to be as independent as possible and a person-centred approach was clearly demonstrated in support plans. People were consulted on the support they received and changes which affected their life. Support plans were regularly reviewed with people to ensure they received the support they wanted.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (01 May 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 01 April 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, need for consent and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for East Cheshire Housing Consortium on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
The management of people's medicines was not always safe.
People who used the service had comprehensive and person-centred risk assessments and care plans to guide staff supporting them. Staff supported people with positive risk taking and understood how to keep people safe.
People who used the service and staff told us they felt staffing was not always sufficient. There had been a high use of agency and casual workers, people told us they were not always satisfied with this. We saw the provider had taken action to recruit the right standard of staff and this had taken some time. However, consistency of the same agency and casual workers had been considered when staffing rotas were devised.
People who received care in their own homes told us they were happy with call times and if a call was missed due to their absence the service would make contact with them.
The provider had systems to guide staff about how to deal with any allegations of abuse.
Staff reported accidents and incidents to the registered manager. The registered manager told us about their plans to improve the way incident analysis was recorded.
The service did not have a policy and procedure to guide staff in how to protect themselves, people who they support and visitors from infectious disease. Staff received training in infection prevention and we were told there had not been any outbreaks of infectious disease.
Pre-admission assessments were detailed and the information collated was formally communicated to the staff team. This meant known risks for individuals were effectively mitigated.
There were shortfalls in training for new and casual staff. Long term staff told us that they had received suitable training to enable them to support people in a safe and effective way. During the inspection the registered manager evidenced scheduled training for all staff.
The provider did not always ensure people's consent to care and treatment was sought in line with the Mental Capacity Act 2005.
People were supported to maintain a healthy lifestyle and they were provided with choice and control.
People told us they felt confident to raise their concerns.
People told us they were supported by staff in a kind, dignified and respectful way. Our observations saw staff engage with people in a genuine and caring way. Staff and people they supported had formed positive relationships and respected each other.
The service involved people in decisions made about their care and supported people to attend regular health and social care reviews. The service engaged with multi-agency professionals and their guidance was recorded and followed.
People were supported to live an enriched life and engage in things that were important for them. The service provided specialist support for people with a broad range of mental health problems and this was done in a person-centred and non-discriminative way.
The service was implementing an end of life and bereavement policy at the time of the inspection. They had made links with the local hospice.
The registered manager was transparent and responsive to inspection feedback. During the inspection they told us about how they would address the failings found at the inspection.
Improvements were needed to ensure the service was assessed for quality and outcomes for people who accessed the service. The service had oversight by two senior support managers and a registered manager who shared responsibilities across all of the schemes. People and staff were aware of who to address should they need to raise a concern or request support.
The culture throughout the service was positive and staff understood their roles and responsibilities.
Rating at last inspection: This was the providers first inspection since their registration had changed.
Why we inspected: This was a scheduled inspection.
Enforcement: We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around the management or medicines, need for consent, staff training and good governance. You can see what action we have told the provider to take at the end of the full report.
Follow up: We will continue to monitor the service and seek an action plan from the provider in response to our inspection findings. We will inspect the service again in line with the rating. We may inspect sooner if we receive information of concern.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk