Background to this inspection
Updated
16 November 2022
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 Health and Social Care Act 2008.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
We gave the service less than 24 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.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with one person who used the service. We observed how staff interacted with people. We spoke with two relatives about their experience of the care provided.
We spoke with 10 staff including support workers, a team coordinator, the assistant manager, the service manager, the compliance manager, the HR manager and two regional directors.
We reviewed two people's care records. We looked at three staff files in relation to recruitment practices. We reviewed various records relating to the management of the service including training records, safety checks and incidents and accidents.
Updated
16 November 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Moorview Care (Derby) is a supported living service. The service supports younger adults living with learning disabilities, autism and mental health support needs. At the time of our inspection Moorview Care (Derby) were supporting three people at one supported living setting in their own flats. The supported living setting can support up to four people.
People’s experience of using this service and what we found
Right Support
People did not always receive consistent support to meet their needs and pursue their interests. The support people received was not always interactive and inclusive. People did not always get support to receive their medicines safely and to be protected from the risk of financial abuse. However, people received support to maintain clean, safe environments, and people were able to personalise their living environments in line with their preferences.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did support this practice.
Right Care
People did not always receive consistent support to meet their needs and pursue their interests.
The support people received was not always interactive and inclusive. People did not always get support to receive their medicines safely and to be protected from the risk of financial abuse. However, people received support to maintain clean, safe environments, and people were able to personalise their living environments in line with their preferences.
Right Culture
People did not always experience a person-centred culture. Improvements were needed to ensure people could lead inclusive and empowered lives. However, staff and the provider did share information openly with people's relatives and other professionals involved in people's care to promote improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 24 July 2022).
Why we inspected
We received concerns in relation to care planning, safety and management oversight of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider took action to mitigate risks to some of our concerns during the inspection, however several concerns remained in other areas.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to people’s safety, safeguarding, person centred care, consenting to care and treatment, staffing and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report. 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.