Background to this inspection
Updated
24 February 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 checked 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 10 and 11 January 2018. We contacted the service two days before the visit to let them know we were inspecting. We did this because they provide a domiciliary care and supported living service and we needed to be sure that someone would be available for the inspection. The inspection team consisted of two adult social care inspectors.
Before the inspection, we reviewed the information we held about the service, including notifications and previous inspection reports. A notification is information about important events which the service is required to send us by law. We contacted the local authority contract monitoring team and had discussions with the local authority safeguarding team. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We had also previously sent questionnaires to people who used the service, relatives, staff and community professionals. We received eight completed questionnaires from people who used the service, five from staff and two from relatives. We used all this information to decide which areas to focus on during the inspection
We used a number of different methods to help us understand the experiences of people who used the service. During the inspection visit, we spent some time with people, observing the care and support being delivered. We talked with five people who used the service about their experiences of their care and support. We talked with three support workers, the registered manager, the nominated individual and two visiting mental health professionals.
We looked at a sample of records, including three care plans and other related care documentation, two staff recruitment records, complaints records, employee hand book, meeting records, policies and procedures, quality assurance records and audits.
Updated
24 February 2018
This inspection took place on 10 and 11 January 2018
This service provides personal care and support to adults living in their own homes. This included a supported living service and a domiciliary care service. 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 provides a service to older adults, younger adults with mental ill health and younger adults with a learning disability.
The service is operated from an office base within a large end terraced house. The house offers tenanted accommodation for up to four people. At the time of our visit 13 people used the service all were receiving a domiciliary care service, which meant they did not receive 24 hour support.
The service was managed by a registered manager. 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.
At our last inspection on the 30 April and 1 May 2015 the overall rating of the service was ‘Good’. However there were some matters which needed improvement, we therefore made recommendations relating to individual risk assessments and supported living tenancy agreements. At this inspection we found sufficient improvements had been made and the service remained Good.
We found there were management and leadership arrangements in place to support the effective day to day running of the service.
Arrangements were in place to ensure staff were checked before working at the service. We found some checks had not been properly completed. But the registered manager took swift action to make improvements.
Systems were in place to ensure staff received ongoing training/learning and supervision. There were sufficient numbers of staff at the service. Support was provided in response to people’s agreed plan of care.
Risks to people’s well-being were being assessed and managed. Systems were in place to support people in maintaining a safe and clean home environment.
Processes were in place to support people with their medicines. We found some matters needed improvement; however these were put right during the inspection.
Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff had received training on safeguarding and protection matters.
We observed positive and respectful interactions between people using the service and staff. People made positive comments about the staff team.
Arrangements were in place to gather information on people’s backgrounds, their needs, abilities, preferences and routines before they used the service.
Each person had detailed care records, describing their individual needs, preferences and routines. This provided clear guidance for staff on how to provide support. People’s needs and choices were kept under review and changes were responded to.
Staff expressed a practical awareness of promoting people’s dignity, rights and choices. Where appropriate, people were supported to engage in meaningful activities the community. Beneficial relationships with relatives and other people were supported.
Processes were in place to support people with any concerns or complaints.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and processes at the service supported this practice.
People were encouraged to lead healthy lifestyles. They were supported with their healthcare needs and medical appointments. Changes in people’s health and well-being were monitored and responded to.
People’s individual dietary needs, likes and dislikes were known. Arrangements were in place to support people with a balanced diet and healthy eating was encouraged.
There were systems in place to consult with people who used the service and staff, to assess and monitor the quality of their experiences and make improvements.