Mencap - Merseyside and Lancashire Support Service

Updated 9 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector.

Service and service type:

This service provides care and support to people living in 35 ‘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.

The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection took place on 8, 9 and 11 April 2019. We gave the provider three days’ notice of the inspection. This was so they could check with people if they were happy for us to visit them in their own homes.

What we did:

Before the inspection

We reviewed notifications received from the service in line with their legal obligations. We looked at information the provider had sent us about the service in the Provider Information Return (PIR). Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also received feedback about the service from different local authorities we contacted.

During the inspection

We visited seven of the 35 supported living services. We looked at six people’s care records and checked records relating to people's medicines. We checked audits and quality assurance reports, incident and accident records, as well as recruitment, supervision and training information. We observed care people received at various times, as well as interactions. We spoke with 13 people who used the service and three people’s relatives.

We spoke with 18 staff members. These included support workers, assistant managers, service managers, an administrator and the two registered managers.

Updated 9 May 2019

About the service:

Mencap Merseyside and Lancashire Support Service consists of 35 ‘supported living’ services across Liverpool, Sefton, Knowsley, Wirral, Wigan, Lancashire and Trafford. At the time of inspection, the service was providing support to 126 people with different health needs, mental health conditions, learning disabilities and/or autism, in their own tenancies.

People’s experience of using this service:

We found and heard some very positive examples, but also identified improvement needs. This is a large service and we considered everything we looked at in proportion, to achieve a balanced judgement based on people’s experience, which was overall very good.

We considered that to support the consistent safety and quality of such a large service through robust planning and overview, record-keeping and governance needed to be improved. We made a recommendation regarding this. We therefore rated Well-Led as Requires Improvement. This is not a reflection on the positive, person-centred and inclusive culture of the service, which everyone we spoke with talked very highly about.

The outcomes for people using the service reflected the principles and values of Registering the Right Support, by promoting choice, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People felt safe with the support from staff. People told us or showed us in their individual ways that they were happy with their care. Staff and relatives told us about the positive, person-centred and inclusive quality of the service. There were enough staff to meet people’s needs and staff support was flexible about individuals’ wishes. Staff felt well supported and told us everyone worked well together to provide a good service for people.

People and relatives told us they had no reason to complain, but that staff listened to them and acted on any suggestions. People were supported to be active in ways that were meaningful to them, as well as encouraged to try new things. Staff helped people to build or maintain new relationships within the service, as well as within the wider community. People, relatives and staff were actively engaged in the design and delivery of the service.

Rating at the last inspection:

At the last inspection we rated the service as Good (19 October 2016). At the last inspection, we rated the service as Outstanding in Caring. At this inspection, we again heard some very positive examples. However, some of our findings showed that this was not consistent across the service and we therefore rated Caring as Good. Further detail is in our Caring findings in the full report.

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating. We found that the service continued to meet the characteristics of Good in most areas we looked at and the overall rating remained unchanged.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and notifications.

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