142 St Marks Road

Updated 13 December 2023

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 team consisted of 2 inspectors and 2 Experts by Experience.

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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats. This service also provides care and support to people living in supported living settings, 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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 needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 13 September 2023 and ended on 21 September 2023. We visited the location’s office on 13 September 2023.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

During the inspection visit, we spoke with 3 people using the service . In addition, we spoke with the nominated individual, registered manager, head of operations, 3 operation managers, 1 positive behaviour support (PBS) lead, 3 PBS officers and 10 support workers.

We reviewed 17 people’s care records which included care plans, positive behaviour plans, transition plans, risk assessments and medicines records. We reviewed 8 staff recruitment records and other documents related to the running of the service which included staff rotas, audits, surveys, meetings and quality assurance records.

We visited 4 supported living locations and we spent time observing the care and support people received. After the site visits, we spoke with 16 relatives and sought feedback from 5 health and social care professionals.

Updated 13 December 2023

About the service

142 St Marks Road (also known as Marcus & Marcus) is a supported living service providing personal care. The service provides specialist support and personal care to people with a learning disability, autistic people and people with mental health needs. At the time of our inspection there were 112 people supported with personal care, living in 41 different properties.

People’s experience of the 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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right support

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. Restrictions were reviewed and creative solutions sought to reduce their use.

Staff maintained exceptional focus on people's strengths and promoted what they could do, this meant people had a fulfilling and meaningful everyday life and opportunities for new experiences. People were supported by staff to achieve their aspirations and pursue their interests. Staff sought opportunities for people to increase their choice and control through environmental and equipment changes, improved communication tools and strategies and skill development. Staff enabled people to access specialist health and social care support in the community. Staff worked collaboratively with people and their circles of support to review progress and find solutions to obstacles.

The service made reasonable adjustments so people could be fully involved in discussions about how they received support.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. People played an active role in maintaining their own health and wellbeing. All restraint and restrictions were recorded and reviewed. Staff learned from these incidents and actions were taken to reduce the chances of people becoming distressed.

Right care

Staff demonstrated effective skills in communication and behavioural support strategies. Staffing levels were adjusted to suit the needs and choices of people. People’s needs were assessed holistically and modelled on best practice, considering individualised approaches to deliver the best outcomes for people.

People's equality and diverse needs were consistently promoted. Staff understood people's individual needs and a multi-cultural workforce provided culturally appropriate care. Staff protected people from poor care and abuse and worked well with other agencies to do so.

People's care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.

Right culture

People led fully inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the provider, management and staff team. It was very clear staff were enormously proud of the work they did in supporting people. People received exceptionally good quality care and support because trained staff and specialists who genuinely cared about people, could meet their needs and wishes.

People were supported by staff who fully understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received exceptionally compassionate and empowering care that was tailored to their individual needs.

Feedback from external professionals about the management team was extremely positive. There was a clear leadership structure, focused on supporting people to develop strategies to rehabilitate and achieve success in life. Staff were focused and inspired to achieve the aims of the service, for people to live as independently as they could whilst championing their rights for equal opportunities.

Staff ensured risks of a closed culture were minimised and 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

Rating at last inspection

The last rating for this service was Good (published 19 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for 142 St Marks Road on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.