Strada Care

Updated 15 February 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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

This service provides care and support to people living in four ‘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 24 hours' notice of the inspection because some of the people using the service could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

What we did before the inspection

We reviewed information we had received about the service since the change in registration. We used information gathered from the service during monitoring calls. This included information provided by the registered manager and feedback from five relatives, an independent advocate and three staff members. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and eight relatives about their experience of the care provided. We spoke with nine members of staff including the provider, registered manager, team leaders and support workers. We received feedback from one healthcare professional working with the service. We visited people in their own home and observed care and support provided to people to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medicines records. We looked at three staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional quality assurance and mental capacity records.

Updated 15 February 2022

About the service

At the time of the inspection Strada Care provided personal care for 19 people with physical support needs, learning disabilities and/or autism in supported living settings, so that they could live in their own home as independently as possible. People lived in accommodation where they shared communal areas of their homes with others and could access support from staff throughout the day and night.

People's care and housing were provided under separate contractual agreements. Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People and their relatives felt staff could recognise and act on any concerns and supported people to stay well and free of avoidable harm. Staff knew people and their individual needs well.

There were enough staff to provide people with support as per their individual needs. The provider addressed any workforce pressures and implemented contingency plans to address those. Staff were trained and competent to support people. Where people needed help to take their medicines, support was provided safely. New staff were recruited safely.

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’s support plans were person-centred, respectful to their own life stories, preferences, wishes, identities and goals. They included clear guidance for staff on how to best support them around their physical and emotional health and how to communicate effectively. People were supported to access healthcare, social care and community services when needed and this was done in a timely way.

People received appropriate support to take care of their homes, prepare meals and to go out when they wished to do so. Staff supported people in a very challenging time when a lot of opportunities were limited by the COVID-19 pandemic and the national guidance on how to stay safe. However, people’s relatives told us staff strived to support people to have a meaningful, happy life despite those challenges.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximised people’s choice, control and independence

People were supported to live in their own homes with others who had been important to them throughout their lives or when they required specialist support to work on improving their independence. Although the design and location of some of people’s homes posed some difficulties to fully adhere to this guidance, the provider had ensured people were not affected and continued to review the model of support. This was as some people’s homes were similar in the design and day to day running to a care home environment. However, the provider mitigated the impact on people by ensuring people received personalised support. We saw people were enabled to live in their own homes, to go out and be as independent as possible whilst previously they might have lived in healthcare settings due to their complex needs.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights

People and their relatives told us staff were respectful, caring and understanding around people’s individual emotional and physical needs. Staff treated people with dignity and respected their human rights. For example, they actively promoted people’s right to family life and helped them to maintain relationships important to them.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives

The registered manager and team leaders knew people well and created a positive culture where people were recognised as individuals and their representatives were involved and listened to as well. The provider continued to review how they supported people and what could be improved to ensure people led the lives they wanted and were safe.

The registered manager was supported by team leaders. The management team reviewed quality and safety of the support provided to people and supported the staff team on a day to day basis. Where improvement actions were identified, this was discussed and remedied. The provider worked effectively with other healthcare, social care and community services so people received timely, joined-up support.

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

Rating at last inspection

This service was registered with us on 8 April 2021 and this is the first inspection since a change of the registered address.

The last rating for this service under the previous address was good (published 26 November 2019).

Why we inspected

The inspection was prompted in part due to information we received from the provider via a CQC direct monitoring call around risk management and the model of the service; and in part as the service was unrated since the change in its registered office address. A decision was made for us to inspect and examine those risks.

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.