24 March 2022
During a routine inspection
Affinity Trust Specialist Support Division North is a supportive living service registered to provide personal care for people who have learning disabilities. Affinity Trust Specialist Support Division North accommodates 15 people across three separate sites, each of which has separate adapted facilities. At the time of our inspection seven people were using the service.
People's experience of using this service and what we found
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 not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support
People were not supported in having choice and control over aspects of their lives. Staff were restrictive and did not promote the best interests of the people using the service. Risks to people were not always recognised, assessed and managed safely. Systems in place did not always protect people from abuse and improper treatment. The provider had not always acted to manage risks. People's needs were not always assessed to consider what they wanted and needed.
Right Care
Staff did not always offer people choice or involve them when supporting with activities or meals. Some staff were knowledgeable about the people they supported and had established good rapport and therapeutic relationships, one relative said, “I like the staff, they know [them] so well”. However, the service relied on agency staff who did not always know the people.
Right culture
The ethos, values, attitudes and behaviours of leaders and care staff did not ensure all people using the service could lead confident, inclusive and empowered lives. People were not supported to regularly identify, or review, on-going individual aspirations and life goals. There was a lack of management support to assist staff in improving practice. Staff told us that morale had been low and they had felt the impact of poor staffing. One staff member said “I just feel undervalued”.
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 19 May 2021 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns raised by stakeholders regarding safeguarding and leadership. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
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 safe care and treatment, person- centred care and good governance at this inspection. We have made recommendations for the provider to improve staff training, supervision and use feedback from people, relatives and staff to inform improvement within the service.
This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Affinity Trust Specialist Support Division North on our website at www.cqc.org.uk.
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.