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Overall: Good read more about inspection ratings

The Care House, Randalls Way, Leatherhead, Surrey, KT22 7TW (01372) 364000

Provided and run by:
Care Management Group Limited

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Background to this inspection

Updated 22 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Why we inspected - This was a routine comprehensive inspection, and was the first inspection of this service since it had registered with CQC. This inspection took place on 22 and 25 May 2018 and was announced. The first day was spent reviewing files in the office, and talking with relatives. The second day was spent visiting people who received support from the service.

The inspection team consisted of one inspector.

Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was reviewed to see if we would need to focus on any particular areas at the service.

We spoke with six people who used the service, and three relatives. We spoke with five staff which included the registered manager who was present on the day. We observed how staff cared for people, and worked together. We also reviewed care and other records within the service. These included four care plans and associated records, four medicine administration records, two staff recruitment files, and the records of quality assurance checks carried out by the staff.

We also contacted commissioners of the service to see if they had any information to share about the home.

Overall inspection

Good

Updated 22 September 2018

Community Support Services (CMG) is a supported living service. At the time of the inspection this service provides care and support to people living in four 'supported living' settings, so that they can live in their own home 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.

This inspection took place on 22 and 25 June 2018 and was announced. There were 17 people using the service at the time of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was at the home during the time of our inspection.

There was positive feedback about the service and the caring nature of staff from people who used it and their relatives.

We have made a recommendation around the management of end of life care. At the time of our visit although some information was present the service did not have detailed information on people’s preferences and personal choices on how they would like to be supported at the end of their life should it arise.

People were safe with the Community Support Service CMG. Staff understood their duty should they suspect abuse was taking place. Risks around people’s health and safety had been identified and discussed with them to minimise these risks. Staff managed the medicines in a safe way and were trained in the safe administration of medicines. Where possible, people’s independence was prompted so they could manage their own medicines.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the buildings they lived in. Accidents and incidents were reviewed to minimise the risk of them happening again.

There were sufficient staff deployed to meet the support hours and needs identified for each individual. The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people. Staff received an induction when they started at the service and ongoing training, tailored to the needs of the people they supported.

Before people moved into the home, their needs were discussed with them and their families to ensure staff could provide the care and support they needed.

People were supported to make their own meals where ever possible. They were supported to have a balanced diet and they were encouraged to keep hydrated. People had enough to eat and drink, and specialist diets either through medical requirements, or personal choices were provided.

People were supported to maintain good health. They had access to relevant healthcare professionals when they needed them. People’s health was seen to improve because of the effective care and support given by staff.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People received the care and support as detailed in their care plans. These care plans were based on goals that people wanted to achieve, and the support needed to achieve them. People were involved in their day to day care decisions. The staff knew the people they cared for as individuals, and were positive in their interactions with them. Staff treated people with kindness and respect.

People knew how to make a complaint. Where comments had been received the staff had responded to try to put things right.

People had access to a range of activities. These were used to promote people’s confidence and independence. They ranged from in-house activities such as doing household chores, to taking part in sport and social activities in the local community.

The registered manager and provider had a clear vision and set of values based on providing personalised care to people. Staff understood this and demonstrated these values during the inspection in their interactions with people. Quality assurance processes were used to make improvements to the service and the experience of people who use it. People were also involved in this process, such as being part of a Quality Checkers initiative.

People and staff were involved in improving the service. People were involved in senior management meetings with CMG to ensure the ‘people’s voice’ was heard. Feedback from meetings and surveys was reviewed and action taken to respond to ideas and suggestions. The management liaised with outside agencies to review and make improvements to the service.