CSL Mablethorpe

Updated 21 July 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

Three Inspectors, and two Experts by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in a number of ‘supported living’ settings, as well as in their own homes, 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 did not have a manager registered with the Care Quality Commission at the time of the inspection. However, a manager was in the process of applying for the post and following the inspection was registered with the Care Quality Commission. There was a nominated individual for the service, the nominated individual is responsible for supervising the management of the service on behalf of the provider. 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 the service 24 hours’ notice of the inspection. This was because people are often out, and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 5 April 2022 and ended on 26 May 2022 We visited the office locations on 5,6,11 April and 9 May 2022.

What we did before 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. This information helps support our inspections. We used all this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We communicated with nine people who used the service and 13 relatives about their experience of the care provided. All the people we spoke with were able to verbally communicate with us.

We spoke with 25 members of staff including, the nominated individual. We spoke with three operations manager, three managers, a deputy manager, a member of the quality monitoring team and 16 support workers.

We reviewed a range of records. This included 12 people’s care records and four medication records. We looked at nine staff files in relation to recruitment and staff supervision. 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 training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 21 July 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

Community support is a service providing personal care for people in their own homes or supported living accommodation in multiple locations across Lincolnshire. At the time of the inspection 49 People were receiving personal care.

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

Right Support

The service supported people to have the maximum possible choice, be independent and have control over their own lives. However, staff did not always demonstrate best practice around documentation of assessment of mental capacity to show the least restrictive options had been undertaken when people were supported with decisions.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests, aspirations and goals.

People living both in a supported living environment or their own homes had a choice about their living environment and how they personalised their homes.

The service made reasonable adjustments for people so they could be fully included in discussions about how they received support, including support to travel wherever they needed to go.

Staff enabled people to access specialist health and social care support in the community. Where needed people were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome. They were supported to play an active role in maintaining their own health and wellbeing.

Staff communicated with people in ways that met their needs.

Right care

Although in some areas of the service people’s care plans had not been reviewed to ensure they still reflected people’s needs, most people’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

The service did not always have enough appropriately skilled staff to meet people’s needs. However, the provider had consistently worked to address the staffing issues at the service and worked proactively to recruit appropriately skilled staff.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. this included people who had individual ways of communicating, using body language, sounds and Makaton (a form of sign language), pictures and symbols, so they could interact comfortably with staff.

People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right culture

The COVID 19 pandemic had a negative impact on staffing and the provider continued to work to address this. They had worked to restructure the service to ensure people were supported by staff who knew and understood them well, and were responsive, supporting people’s aspirations to live a quality life of their choosing.

Although there had been a large number of anonymous whistle blowers about the service. All the concerns were investigated by the provider and their quality monitoring team. Where necessary actions had been taken to protect people. The culture of the management team was open, and they continued to work to ensure closed cultures which could impact on people’s quality of life at the service did not develop.

We saw in some areas staff evaluated the quality of support provided to people, involving the person and those important to them, including advocates, to be involved in planning their care.

There were some areas of the service where this process required some improvement. The provider was aware of this and was working to address the issue.

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. The changes to the management team and structure of the service was beginning to show a positive impact on people’s lives.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

The last rating for this service was Good (published 21 April 2021).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support Right care Right culture. The inspection was prompted in part due to concerns received about allegations of abuse, staffing and management culture. A decision was made for us to inspect and examine those risks.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner