11 July 2018
During a routine inspection
This service provides care and support to nine people living in six small ‘supported living’ settings, so 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.
This inspection had been brought forward due to concerns. This was because staff had raised concerns about safeguarding incidents that had occurred. These had not been reported to the local authority or to the Care Quality Commission, and had not been investigated by the provider. This meant vulnerable people had not been protected and safeguarding adults’ protocols had not been followed. Also, the provider’s quality monitoring processes were not effective in identifying gaps and shortfalls in the quality and safety of the service.
People were supported with their medicines in a safe way but there was no guidance for staff about when to support people with over the counter or ‘when required’ medicines. We have made a recommendation about this.
Staff told us they had not always felt well supported and had not received some of the training they needed. We have made a recommendation about this. Individual supervisions with staff had not been held in a confidential way. On-call management arrangements had not always been supportive to staff who worked with people who used the service. The provider showed us how these issues were being addressed.
There had been a registered manager at the service but they retired in November 2017. A new manager had applied for registration but left the organisation during this inspection. Another manager (from the organisation’s education department) was acting as manager in the interim until a new manager could be appointed. 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.
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.
People were fully included in their local community and lived ordinary, fulfilled lives as local citizens. They took part in meaningful occupations, such as farming and gardening. They also enjoyed a number of individual leisure activities that they were interested in.
People were treated with dignity and respect. They were encouraged to make their own decisions and to lead as independent lives as possible.
People who could express a view felt the staff were caring and kind. People said they “liked” the support workers and described them as “nice”.
Staff were extremely knowledgeable about individual people and were aware of their individual preferences. People were supported to do their own shopping and make their own meals, with support only where needed.
The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA 2005). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; they understood the need to obtain consent when providing care. Staff had completed training in relation to the MCA 2005.
Senior manager had recently identified a number of areas for improvement and development. The organisation was committed to implementing those improvements and was considering better ways of monitoring the service in future.
We found two breaches of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. These related to safeguarding people and good governance. You can see what action we told the provider to take at the back of the full version of the report.