Background to this inspection
Updated
22 December 2018
The Inspection:
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.
The inspection team:
The inspection team consisted of one adult social care inspector.
Service and service type:
This service provides care and support to people living in ‘supported living’ settings, so that they can live in their own home 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.
Not everyone receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in post. 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.
Notice of inspection:
This inspection was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the management would be in the office. We visited two households on 26 October 2018 and one household on 31 October 2018. We visited the office location on 15 November 2018 to see the registered manager and office staff; and to review care records and policies and procedures.
What we did:
Prior to the inspection we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse and deaths. 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 also sought feedback from the local authority and health care professionals. We used all this information to plan our inspection.
During the inspection, we spoke with five people who used the service and one relative to ask about their experience of the care provided.
We spoke with five members of staff which included two service managers and the registered manager. We reviewed a range of records. This included three people’s care records. We also looked at five staff recruitment files and the service’s staff training records. Other records reviewed included a selection of audits and the service improvement plan.
Updated
22 December 2018
What life is like for people using this service:
People told us they felt safe. They were protected from potential abuse and discrimination. Risks to people were identified, assessed and action taken to reduce these or remove them. People lived in a clean and safe environment. Medicines were managed safely and staff provided the support people needed to take their medicines as prescribed. Enough suitably recruited and skilled staff were deployed to meet people’s needs.
People’s health needs were assessed and people had access to a variety of healthcare professionals to support them. People were provided with the right amount and type of food to meet their health needs, and people were supported to do their own food shopping and prepare their own meals. People’s religious preferences were being met. At the time of our visit there were no diverse cultural needs requiring support, but staff explained that this would not be a problem if there were; these would be respected and met.
The principles of the Mental Capacity Act 2005 were followed. People were supported to make independent decisions and their care was delivered in the least restrictive way possible. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
For people living in their own home or in shared domestic settings, this would be authorised via an application to the Court of Protection (COP).
Staff were kind and caring towards people. They maintained people’s dignity and privacy. People’s choices, preferences and wishes were known to the staff who had taken time to find these out. Care plans gave staff guidance on how to meet people’s needs. Further detail about people’s care needs was also communicated to staff by means of staff handover meetings and daily notes.
The service had a registered manager in position. 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.
Rating at last inspection:
The last inspection was in August and September 2016 when the service was rated as ‘Good’ overall. At our previous inspection, the Responsive domain was rated as ‘Requires Improvement’ because some people were not supported to reach their full potential. Goals in people’s support plans were not updated or reviewed for long periods of time to show any outcomes or completion dates. The service had made improvements and this is now rated as Good.
The service remains ‘Good’ overall.
Why we inspected:
This inspection was partly prompted by quality concerns from a visiting health professional and this indicated potential concerns about the management of risk in the service. We looked at the concerns identified and all the associated risks.
About the service:
This service provides care and support to people living in ‘supported living’ settings, so that they can live in their own home 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.
Not everyone receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.
Further information is in the detailed findings below.