Archived: Richmond Community Support

Updated 22 August 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in two supported living settings, 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.

The service had a manager registered with the Care Quality Commission. 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

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 31 July 2019 and ended on 5 August 2019. We visited the office location and one supported living service on 31 July 2019 to review records and speak with people.

What we did before the inspection

We reviewed information we had about the service. We sought feedback from two relatives and a healthcare professional who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed three care plans, three medicine administration records, policies and procedures, risk management plans, communication passports and other records related to the management of the service. We spoke with five staff members, including two care workers, the care coordinator, registered manager and the operations manager.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, staff files and rotas.

Updated 22 August 2019

About the service

Richmond Community Service is a supported living service providing personal care to people with learning disabilities or autistic spectrum disorders and physical disabilities at the time of the inspection. The service can support 12 people in two purpose-built houses.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. Staff consistently applied effective proactive strategies to prevent behaviour that challenges.

People’s experience of using this service and what we found

People received care and support from staff that understood their roles and responsibilities in safeguarding people from abuse. Identified risks to people were clearly documented and staff had clear guidance on how to mitigate those risks. There were suitable numbers of staff deployed to keep people safe. People’s medicines were managed in line with good practice. People were protected against the risk of cross contamination as the provider had robust infection control measures in place.

Newly employed staff underwent a comprehensive induction and reflected on their working practices regularly. People were supported to prepare and access sufficient food and drink to meet their dietary needs and preferences. People’s health and wellbeing was regularly monitored, and people had access to a wide range of healthcare professionals when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with respect and had their diverse needs encouraged. People’s dependency levels were assessed prior to living at the service. People were encouraged to maintain their independence wherever possible.

Care plans were person-centred and regularly reviewed to reflect people’s changing needs. People were encouraged and supported to participate in both in-house and community-based activities, in line with their preferences. The provider had an accessible information standard policy. People were encouraged to raise concerns and people's relatives confirmed they would raise concerns if required. People's end of life wishes were documented.

The registered manager had clear oversight of the services and spent her time equally at each service. People’s relative’s spoke positively about the registered manager. Staff confirmed they could speak with the registered manager at any time and that she was available to them. The registered manager carried out regular audits and worked in partnership with stakeholders to drive improvements.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The service was registered with us on 30 May 2018 and this is the first inspection.

Why we inspected

This inspection was planned in line with our inspection programme.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.