Archived: Channel Homes (UK) Ltd

Channel Homes (UK) Limited is a supported living service in a cluster arrangement that supports up to 18 people with learning disabilities some of whom also have other needs. People have the tenancy of their own flat.

At inspection the registered manager confirmed that of the 18 people in receipt of the service there was only one person in receipt of minimal ‘personal care’ support; our inspection therefore was only able to reflect the service this person received and how their needs were being met.

Rating at last inspection

At the last inspection, the service was rated Good overall with a Requires Improvement in the ‘Well Led’ domain'.

Why we inspected

We carried out an announced comprehensive inspection of this service on 13 & 14 April 2016; this was to ensure that someone in authority would be present in the office to provide us with access to important documentation. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 17 of the Health and Social Care Act Regulated Activities Regulations 2014, Good Governance. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report

only covers our findings in relation to those requirements. You can read the report from our last

comprehensive inspection, by selecting the 'all reports' link for Channel Homes (UK) Limited on our website at www.cqc.org.uk

At this inspection we found the service remained Good overall and is now rated Good in the Well Led domain.

Why the service is rated Good

People told us they were very happy with their support and that the registered manager and staff involved them in discussions about their support needs. They appreciated the flexibility of the support and how they could change how and when their support hours were sometimes delivered.

The service had improved since the last inspection. Audits to check on a range of areas regarding the person’s support had been implemented; this provided assurance to the registered manager and the provider that the person was being supported appropriately. The registered manager continued to take responsibility for updating care and risk information to reflect any changes in people’s level of independence or needs. This was always discussed with the person. The registered manager undertook unannounced ‘pop ins’ to see people as part of the checks she made, and by covering some shifts was available to people in a less formal capacity if they wanted to talk about the service or raise concerns.

Staff said there was a very good sense of team and staff were supportive of each other. The provider and registered manager were a visible presence and staff said they found them approachable and easy to talk with. Staff said communication was good and they felt listened to and empowered to make suggestions and ideas to improve the service.

Staff were given opportunities to meet together and discuss issues that arose. They were confident in dealing with incidents and or accidents and knew how to keep people safe from harm. Staff knew their responsibilities to record and report incidents, accidents or issues that arose to the registered manager.

Staff were provided with a range of policies and procedures relevant to inform their work and the provider and registered manager updated these as changes in best practice or legislation occurred, and updated information was relayed to staff who were asked to read amended or updated policy or guidance and sign when they had. For example, the registered manager and staff understood the principles of the Mental Capacity Act 2005 and how this applied to people living in supported living services.

The provider and registered manager had good links with supported living networks and care professionals in the local area; they participated in conferences and workshops driving improvement in the delivery and expansion of supported living.

People told us that they were asked to comment about the service they received through regular checks made with them by the registered manager who also asked the person to complete a survey from time to time. Their feedback was analysed and any identified issues were addressed to the person’s satisfaction.

The registered manager understood their responsibilities to inform the Care Quality Commission of significant events where required.

Formal systems to assess and monitor service quality were not in place and although feedback from staff, professionals and the person indicated they thought the registered manager provided effective leadership, undertook spot checks and kept a close eye on how the service was running the lack of quality monitoring system meant the registered manager could not provide assurance that all aspects of their service were operating well. As a director of the company the registered manager had a dual role and she had a visible presence within the service supporting shifts as and when required; she undertook informal monitoring of service quality but there was an absence of recording to show what was checked, what shortfalls were found and how these had been addressed. The views of staff and all people using the service were sought and acted upon but not on a regular basis.

External stakeholders commented positively about the service stating that it was well led, provided an excellent service to improve outcomes and independence for people and that the service communicated well with them.

The service was required to have a registered manager and one was in place. 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 person receiving the regulated activity spoke positively about the scheme and the availability of a staff member 24 hours per day except during the day on Sundays. Since moving to the service they said they that they had grown in confidence because of the support they received from staff. They had choices about who worked with them, and how they wanted to use their allocated staff time. They had their own door key and staff entered only by invitation respecting the person’s privacy, dignity and right to a private life. Staff supported the person to take care of their own health and prompted and supervised them to access healthcare as required.

Staff said they were happy in their roles and felt well supported; they had opportunities to meet with the registered manager individually and participated in comprehensive handovers each day. Staff retention was good. A previous inspection had highlighted shortfalls in the documentation gathered around staff recruitment the registered manager had made improvements to ensure files of longstanding staff members better meet the requirements of the regulations. People using the service were involved in the recruitment of new staff and their feedback about prospective candidates was valued and taken into consideration.

The previous inspection highlighted shortfalls in the training and annual appraisal of staff. The registered manager had taken action to address this. This inspection found staff were provided with an appropriate level of training and induction to inform and understand how to meet the needs of people using the service. A system had been implemented for the annual appraisal of staff.

Staff knew how to keep the person safe and the actions they needed to take in the event of an emergency, accident or safeguarding event. The persons support plan was individualised and guided staff in providing the appropriate level of support, where risks were highlighted these were recorded and the measures for reducing risk levels. The person stored, and administered their medicines but sometimes needed staff support to administer a prescribed cream.

We observed staff interaction with the person to be warm and caring, with humour and patience. The person was comfortable to meet with us and a staff member who they clearly welcomed into their home, they chatted happily with staff sharing information with us about the support they received.

The person was supported by an established and, motivated staff team. The person and staff said that there were enough staff to enable flexible support of the person’s individual needs.

The person had capacity but was protected from decisions being taken without their involvement because staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and were working to its principles and this legislation should be interpreted in their daily support and practice.

The person in receipt of the regulated activity said they were confident of being able to raise concerns if they were unhappy with the service they received. The service sought people’s views from time to time to inform service development.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

During this inspection we spoke with two people who used the service. We also spoke with the registered manager and three staff. We reviewed four care plans and three staff records.

Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at.

Is the service safe?

Improvements were required to the recruitment procedures to ensure people using the service were safe and staff had been appropriately vetted to work with vulnerable people.

People told us that they felt safe, and we found that the service had systems in place to keep people safe.

We saw that the risks associated with people's care and support had been assessed and there was guidance for staff to follow to make sure people's care was delivered safely

There were sufficient numbers of staff on duty to help ensure people's care and support needs were fully met.

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DOLS). There were no Deprivation of Liberty Safeguards authorisations in place, and no applications had been made.

Is the service effective?

Improvements were required to make sure the service was effective by providing staff with updated training and a yearly appraisal to identify their training needs and professional development.

People's needs were assessed before they started to receive a service. People had access to health care professionals to help make sure their health care needs were met.

People told us that they were 'happy' with the care and support they received. It was clear from speaking with staff that they understood people's care and support needs and that they knew them well.

Is the service caring?

People using the service lived in their own flats within a small area and were supported by staff to remain as independent as possible. They told us that staff supported them well and encouraged them to do things for themselves. They said: 'The staff are good'. 'The staff are OK'.

During the inspection staff demonstrated a kind and caring approach when discussing people that used the service. They gave examples of how they supported people with their privacy and dignity by prompting them to close doors and curtains. They talked about how they made sure people were being supported to manage their daily lives. People told us how they were supported by staff to attend the doctors or go shopping.

Is the service responsive?

People using the service received allocated one to one support from a member of staff. In addition there was a member of staff available 24 hours that they could access if required. People told us that this system worked well and there was always a member of staff around to respond to their calls.

People told us staff arrived on time to provide their one to one support. They said: 'I like living here; the staff always come on time when I have my support call'. 'They always come when they should'.

We saw and heard during the inspection that some people were able to make their views known about what they wanted in relation to their day to day care and support. We saw that staff respected these wishes and encouraged them to make decisions about their care.

Care plans had been routinely updated so that all staff were aware of people's current support needs.

Is the service well-led?

Improvements were required to make sure the service was well led.

The registered manager had not made sure that there were effective systems in place to monitor the staff training so that staff had the latest guidance to perform their role.

Staff felt supported by the registered manager, they told us that they had one to one meetings to discuss their role. They said that they felt comfortable in taking any concerns forward and they would be acted upon.

At our previous inspection, we found that people who used the service, their representatives and the staff had not been given the opportunity to comment, make suggestions or offer feedback about the service provided.

At this inspection we found that the provider had put procedures and systems in place to ensure that people, staff and other agencies with a professional interest in the service, had the opportunity to comment and feedback about how the service was run. We found that people had also been invited to offer suggestions about any improvements the service could make.

The people we spoke with said they had many interests and things to do, and told us what they needed support with. We saw that the care records included people's views and the choices they had made about their individual support plans. The staff we spoke with were aware of people's preferences and needs.

The people we spoke with said they would go to staff if they had any problems, concerns or worries. They told us that the staff supported them well. One person told us 'staff are respectful; they treat me very well'.

We found that the provider had not undertaken any surveys or meetings with the people who used the service, or the staff, to gain feedback about the service and how it was provided.

We found that there were sufficient staff on duty, who had a range of experience and qualifications relevant to supporting people's needs.

We found that the service kept records safely and stored them appropriately, to ensure people's details and information was protected.