Archived: Normanshire - Supported Living Services Ltd

Normanshire – Supported Living Services Ltd provides personal care and support in five settings to people with learning disabilities and autism who may have behaviour that challenges services.

People’s experience of using this service

We were unable to fully inspect the service because there was no information kept at their registered address. Concerns had been raised about staffing levels and we were able to check records about numbers of staff on duty from rotas sent to us following our visit. Records showed people were not being supported by competent staff due to staff working excessive hours without a reasonable rest break or being rostered to work at more than one setting at the same time.

The provider had moved address and was operating from an address that was not registered with the Care Quality Commission. The provider had not picked up on the issue of staff being rostered on at more than one location at the same time or on the issue of staff working excessive hours.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staffing and good governance. We found one breach of the Care Quality Commission (Registration) Regulations 2009 in relation to the provider’s registration.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21/12/2018).

Why we inspected

We received concerns in relation to the management of medicines and staffing. As a result we undertook a focussed inspection to review the Key Questions of safe 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 the previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Normanshire Supported Living Services Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the provider's registration, staffing and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Normanshire - Supported Living Services Ltd provides care and support for people living in a 'supported living' setting, 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. Normanshire - Supported Living Services Ltd provides a service to four people with learning disabilities, across two sites in the Waltham Forest and Redbridge area.

The service had been developed and designed prior to the development of the values that underpin the Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. However, we saw that people with learning disabilities who used the service were able to live as ordinary a life as any citizen. We saw that people's homes did not house more than six people.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People and a relative told us they felt the service was safe and there were enough staff to meet their needs. Staff were trained in safeguarding and knew how to safeguard people against harm and abuse. People’s risk assessments were completed, regularly reviewed and gave sufficient information to staff on how to provide safe care. Staff kept detailed records of people’s accidents and incidents. Staff wore appropriate protection equipment to prevent the risk of spread of infection. Medicines were stored and administered safely. The management of people’s finances was not robust however management told us they would start checking people’s finances on a daily basis.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. People who had capacity to consent to their care had indicated their consent by signing consent forms. However, where people lacked capacity to consent to their care the provider had not followed the principles of the Mental Capacity Act (MCA) 2005. We have made a recommendation about following the principles of the MCA.

Staff undertook training and received regular supervision to help support them to provide effective care. People were supported to choose what they ate and drank.

People and a relative told us staff and the service was caring. Person centred support plans were in place and people were involved in planning the care and support they received.

People had access to a wide variety of activities within the community. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The provider had a complaint procedure in place. People knew how to make a complaint.

Staff told us the registered manager was approachable and open. People liked the registered manager and found her helpful. The service had various quality assurance and monitoring mechanisms in place.