Background to this inspection
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 Health and Social Care Act 2008.
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 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we wanted to ensure the provider would be available when we carried out the inspection
We inspected two of the supported living homes on 14 June 2022 and visited the office on 15 June 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 three people who used the service and three relatives about their experience of the care provided. One of the people we communicated with was able to verbally communicate with us the other two people used body language and gestures to communicate with us.
We spoke with seven members of staff including the registered manager, home managers, senior support workers and support workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four 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. 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
An Darach Care Lincolnshire is a community supported living service. The service provides personal care support to young adults who live in their own homes independently in the community. At the time of the inspection the service was providing care for 13 people who experienced needs relating to learning disabilities and autism. Each person had a tenancy agreement in place. At the time of the inspection there were four supported living houses, with between two to four people living in each house. There were staff supporting people in each house 24 hours a day.
People’s experience of using this service and what we found
Right Support
People were supported to have maximum choice and control over their lives. The Mental Capacity Act (MCA) principles were followed when assessing mental capacity and in making best interests' decisions. Improvements had been made at the service to ensure that people were encouraged and supported to be as independent as possible.
Care plans focused on people’s strengths. The registered manager was working with one of the staff teams to ensure a consistent approach across the service.
Right Care
Peoples care, treatment and support plans had been improved since our last inspection to be more person centred. People were supported by using communication styles that met their needs.
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 were supported by kind and caring staff who had received appropriate training. People’s families told us they felt their relatives were safe at the service. Staff had received training on how to recognise and report abuse and they knew who to report to.
Right culture
Since our last inspection, the provider had made improvements, to the management structure, with the appointment of a registered manager who had oversight of all four homes. The registered manager had been working with staff teams to challenge areas of poor culture. Not all staff had been receptive to these changes and had left the service. The provider had ongoing challenges with recruitment and used agency staff to ensure staffing levels were effective and met the needs of the people at the service. The provider worked with agencies to ensure the same staff worked at the service in order to ensure consistency for the people who were being supported. Agency staff received the same training as the long-term staff team in order to understand and work with people around their specific needs.
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.
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 rating at the previous inspection was requires improvement (published 14 October 2021). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The overall rating for the service has changed from requires improvement to good. Based on the findings at this inspection.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 17 (Good governance) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 (Staffing), of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, had been met. All had been met.
We also undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
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.