Background to this inspection
Updated
4 December 2019
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
One inspector carried out this inspection.
Service and service type
This service provides care and support to people living in three supported living setting’s, 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
This inspection was unannounced.
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 and professionals who work with the service. 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.
During the inspection
We visited, spoke with and observed the care of one person who lived in one of the bungalows on site, and with three people who lived in the house. We contacted three relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, acting deputy manager, health and safety manager, and care workers.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality audits and feedback questionnaires.
Updated
4 December 2019
About the service
FitzRoy Supported Living Uckfield is a supported living service providing personal care to six adults with a learning disability and/or associated conditions, in one house and two bungalows to live independently in their own rented properties.
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.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Records still needed to improve in areas such as how complaints are formally recorded and end of life planning. Care plans were becoming person centred and detailed with information for staff to follow. The service was in the process of imbedding practices and sustaining improvements in these areas.
Since the last inspection there had been a significant change in atmosphere, culture and care. The provider had recognised the registered manager needed to be more available and on site to effectively support the required changes to ensure people’s quality of care improved. The registered manager said, “We have worked very hard to bring this back to a good service. Yes, there are things we need to do. Everything is organic and we will work hard to get this completed. We will work with the staff, people and their families to get it right.”
People told us they felt safe receiving the care and support provided by the service. Staff understood and could recognise the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk. Risk was identified and recorded with clear guidance for staff to reduce it as much as possible and people were assisted to access healthcare services when needed. Medicines were managed safely and administered by trained staff.
The atmosphere at the service now felt like a family home. People were free and eager to chat with staff and anyone who came to their home. There was a busy schedule which involved most people going out each day with staff to different activities. People were cared for by a staff team who were kind and thoughtful.
People's care and support needs were assessed before they started to use the service. Staff had the skills, knowledge and experience to support people appropriately. Staff were supported through induction, training and regular supervision. People were supported to maintain a healthy balanced diet and had access to health care professionals when they needed them.
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. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.
People, relatives and staff were engaged by the service through meetings, so everyone could contribute to the development of the service. There was a credible strategy in place with plans for staffing improvements at the service. This was being implemented by the registered manager who was pro-active in considering how the service could be improved.
Without exception people, relatives, professionals and staff spoke highly about the management and improvements to staff morale and team work. The registered manager had worked in partnership with health and social care providers to plan and deliver an effective service.
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 Inadequate (published 22 July 2019) and there were four breaches of regulation. We imposed a positive condition, meaning the registered provider had to provide a report of the actions they intended to take to meet all the breaches of regulations. This report had to be submitted to the CQC on the first Monday of each month.
The provider completed this report each month and met the imposed positive condition. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since July 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.
We have found evidence the provider needs to sustain improvement. Please see the responsive and well led sections of this full report.
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.