Background to this inspection
Updated
30 March 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 two inspectors.
Service and service type: This service provides care and support to people living in 14 ‘supported living’ houses, 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.
Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service had a manager registered with the CQC. 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: Our inspection was announced to make sure people and staff would be available when we visited.
What we did: Before the inspection we checked information we held about the service. This included notifications the provider had sent us about events or incidents that had occurred and which affected their service or the people who used it. We contacted the local authority’s adult safeguarding and quality monitoring team as well as Healthwatch England, the national consumer champion for health and social care, to ask if they had any information to share.
The provider completed the Provider Information Return. This is information providers must send us to give us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection we visited the location offices and two supported living services to speak with people and review records. We also telephoned people to gather their feedback about the service. Overall, we spoke with four people who used the service, eight people’s relatives, the registered manager and nine members of staff.
We looked at four people’s care plans, risk assessments, daily notes and medication administration records. We reviewed three staff’s recruitment records, as well as induction, training and supervision records for the staff team. We reviewed meeting minutes, quality assurance audits and a selection of other records relating to the management of the service.
Updated
30 March 2019
About the service: This service is a domiciliary care agency providing personal care to younger adults and older people. The service specialises in supporting people with a learning disability or autistic spectrum disorder, a physical disability or who may be living with dementia. Thirty-six younger adults and older people were receiving support at the time of this inspection.
People's experience of using this service: People were happy with the support staff provided. Staff were kind and caring; they provided person-centred care to meet people’s needs.
The outcomes for people using the service reflected the principles and values of Registering the Right Support in the ways staff promoted inclusion, choice and control and supported people to gain new skills and become more independent.
People told us they felt safe or acted in a way which showed us they were comfortable and at ease with the support that staff provided. Staffing levels met people’s assessed needs. Staff had been trained to recognise and respond to risks and signs of abuse. People felt comfortable speaking with staff if they were worried, concerned or needed to make a complaint.
Staff understood people’s needs and the risks to their safety. Risk assessments guided staff on how to safely meet people’s needs.
We have made a recommendation about recording more consistently detailed information about how accidents and incidents were managed.
Staff spoke with people in respectful way and supported people to maintain their dignity. People routinely made choices about their care and support. Staff understood the importance of consent; people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
We have made a recommendation about developing documentation in relation to mental capacity assessments and best interest decisions.
Staff had regular training, and a system of supervisions and appraisals helped the registered manager to monitor their performance and support their professional development.
Care plans provided detailed information about people’s needs to support staff to provide person-centred care. Plans were in place to guide staff on how best to support people who might become anxious or upset. Staff worked with professionals and responded to their advice to make sure people’s needs were met.
Staff supported people to take part in regular meaningful activities and to pursue their hobbies and interests.
The registered manager used audits to monitor the quality and safety of the service. They listened to people’s feedback and responded to issues and concerns to continually improve the service.
For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.
Rating at last inspection: At the last inspection service was rated requires improvement (report published 26 February 2018).
Why we inspected: This was a planned inspection based on the pervious rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.