Archived: Progressive Support

Updated 2 February 2019

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.

This inspection took place on 14 December 2018. The inspection was carried out by an adult social care inspector.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Before our inspection visit, we reviewed the information we held about Progressive Support. This included looking at the notifications we had received from the provider about any incidents that may have impacted on the health, safety and welfare of people who used the service. We also looked at the Provider Information Return (PIR). This form asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We had not received a PIR on this occasion, despite requesting one. Additionally, we approached local stakeholders for feedback about the service. We used this information to help us populate our ‘planning tool’ which determines how the inspection should be carried out.

During our inspection we spoke with two people who used the service, one relative, the manager, office manager, registered provider and three staff. We also visited one person at their home and spent time talking to them.

Updated 2 February 2019

This inspection took place on 14 December 2018.

Progressive Support is an organisation which provides support to people living in the community. At the time of our inspection, four people were in receipt of the regulated activity ‘personal care.’ There were other people using the service, however they were not in receipt of any regulated activity.

This service provides care and support to people living in ‘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 is the registered providers first inspection since they moved locations.

There was not 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.

Additionally, we had not been sent a PIR from the registered provider when we requested one.

There were audits in place which checked service provision. We saw, in the most part, these audits were robust and had identified when improvement was needed. There were some issues discussed during our inspection regarding audits and their frequency and effectiveness. We have made a recommendation regarding this.

Everyone we spoke with said they felt safe receiving support from Progressive Support.

Medication was safely managed for people in their homes. Staff were only permitted to administer medication to people once they had been trained in the principles of medication administration and had completed a competency test.

Risk assessments were in place for each person and contained relevant and up to date information. Risk assessments contained information around what action the staff needed to take in order to keep people safe.

There were systems and processes in place to ensure that people were protected from potential harm and abuse. Staff we spoke with described the action they would take if they felt that abuse had occurred, and this included reporting the abuse to their line manager, or whistleblowing to external organisations such as CQC, the Local Authority or the police.

People were supported to ensure regular maintenance took place for their homes.

Staff were recruited safely. Each staff member had two references in place in their files and there was evidence that a Disclosure and Baring Service (DBS) check had taken place.

Personal Protective Equipment (PPE) was available for all staff to use. Staff we spoke with confirmed there were gloves and aprons in people’s homes and an additional stock of these were kept in the registered office for their use.

There was a log of incident and accidents which was kept securely at the registered office. Each time an incident or accident occurred the manager analysed the incident in detail from the information provided by staff which was recorded on the incident form.

There was enough staff employed by the service to cover the support hours people needed.

Staff confirmed they had regular supervision with their line manager. Records relating to staff training and supervision were however not always clear and consistent, even though they had taken place. We discussed this at the time with the manager. The manager informed us they would take action and update these records.

Capacity was appropriately assessed. Records clearly indicated where people had provided their consent to receive care and support from Progressive Support and in other instances decisions were appropriately made in the persons ‘best interest’ and in the least restrictive way as possible.

People confirmed they were supported with their nutrition and hydration needs by the staff. People were supported with meals of their choice and their staff helped them shop and plan these meals.

Health and social care professionals were communicated with when needed in order to help people with their medical needs.

Everyone we spoke with and our observations showed that people received support which was caring. People were treated with dignity and respect. Staff members whom we spoke with said they always tried to ensure people’s independence was encouraged

All confidential and sensitive information was securely stored and protected in line with General Data Protection Regulation (GDPR).

Information recorded in the care plans we viewed was centred round people’. Support plans contained information how the person liked their care routine to be carried out and how they like to be communicated with.

Complaints were documented and responded to appropriately. We saw that all complaints had been resolved and there were none outstanding. The complaints policy had been made available to people in the service user guide, and everyone we spoke with said they knew how to complain.

Most information was available for people in alternative formats. We saw copies of some support plans and polices which could be provided in different formats when requested to support people’s understanding. Some had already been converted to involve people. The service was further developing their procedures in relation to this to enable them to offer even more accessible way of providing information to people.

Staff had completed training in end of life care.

We discussed lessons learnt with the manager, and where they felt they had strived to make improvements when things went wrong.

Staff we spoke with said they felt the manager was approachable and available to listen to them.

Staff said the culture of the service was personable and friendly and every staff member we spoke with said they enjoyed working at Progressive Support.

Team meetings took place every month. We saw minutes of the last few months and saw copies of these were shared with staff. Agenda items included medication, training, rotas and health and safety.

The service worked collaboratively with other services such as the Local Authority, learning disability nurses and district nurses.

There were polices in place for staff to follow. We discussed that some of the polices would benefit from having a review date on them as we were unsure when the policy was from. The manager has since actioned this.