Continuum Care (Cornwall)

Updated 25 March 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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. The Expert by Experience was a person who had personal experience of caring for someone who uses domiciliary care services.

Service and service type

This service provides care and support to 10 people with learning disabilities or autism living in ‘supported living’ settings, so that they can live as independently as possible. In addition, the service also supports approximately 25 older people who live in their own homes.

In the supported living settings 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.

There was a registered manager in post at the time of the inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we intended to visit people in their own homes, and it was necessary to give the service time to gain consent for these visits to be completed.

Inspection activity started on 30 January 2023 and ended on 2 February 2023. We visited the service on 30 and 31 January 2023.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection as part of the planning process. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We visited 3 supported living settings and met with 2 additional people who received supported living care in the service’s office. We also spoke by telephone with 4 relatives of people using the supported living service and with 5 people and 5 relatives of people supported by the domiciliary care service. In addition, we met and spoke with 10 staff and the registered manager and gained feedback about the service’s current performance from 2 health and social care professionals.

We looked at records relating to people’s care and the management of the service. This included 5 care plans and associated risk assessments, medicine administration records (MARs) and staff 4 recruitment and training records.

We also asked the service to send us records relating to the day to day management of the service and quality assurance audits. This information was reviewed in detail after the site visit.

Updated 25 March 2023

About the service

Continuum Care (Cornwall) provides supported living care for people with learning disabilities and domiciliary care for older people living in Falmouth, Camborne and Redruth areas of Cornwall.

At the time of our inspection 10 people were receiving supported living care and approximately 25 people were receiving personal care in their own homes from the domiciliary service. The 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

Supported living service

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 model of care maximised people’s choice control and independence. In each of the settings we visited people were able to choose what to do each day and staff respected those decision and choices. Staffing levels reflected people’s needs, and where additional staff were required to enable people to safely engage with more risky or challenging activities this was arranged. People were encouraged to do as much as possible for themselves and had been supported to gain the skills necessary to enable them to gain voluntary work placements.

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; the policies and systems in the service supported this practice. Staff and managers communicated with people effectively and supported people to make meaningful decisions and choices. Where people lacked capacity and there were restrictive care practices in place these practices had been reported to the local authority for authorisation by the court of protection.

Right Care:

Staff cared for the people they supported and understood their role in ensuring people were protected from all forms of abuse and discrimination. Staff took evident pleasure and pride in describing people’s recent achievements.

Right Culture:

The supported living service was well staffed. Relatives and health professionals were complimentary of the positive impact the service had on people’s welling, communication and quality of life.

Domiciliary care service

The provider had experienced challenges in relation to the recruitment of staff able to drive for the domiciliary care service. As a result, the provider was not currently accepting new packages of domiciliary care.

Staff rotas included appropriate travel time and people told us their carers normally arrived on time and stayed for the full duration of each visit. Missed visits had occurred infrequently and the service learned from these instances and identified the need for additional processes to be introduced in order to reduce the risk of visits being missed in future.

Staff in both divisions of the service staff were recruited safely and were well supported by their managers.

Quality assurance processes were effective and both divisions of the service regularly received compliments about the quality of care provided. The service communicated effectively and people and relatives knew how to contact the registered manager if necessary.

Medicines were managed safely and there were appropriate infection control procedures in place.

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 the service was Good published on (4 June 2021). At this inspection the services rating has remained Good.

Why we inspected

This inspection was prompted by information we had received which indicated there had been a significant change in how the service operated, as the number of people receiving supported living care had significantly increased. As a result, we undertook a focused inspection to review the key questions of Safe, responsive and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Continuum Care (Cornwall) on our website at www.cqc.org.uk.

Recommendations

We have recommended the provider seeks advice on how to ensure information is accurately transcribed into medicines administration records.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.