Background to this inspection
Updated
9 February 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on January 2018 and was announced. We gave the service 24 hours notice of the inspection visit because the location provides a domiciliary care service for younger adults who are often out during the day. We needed to be sure that they would be in.
The inspection team consisted of one adult social care inspector and an Expert 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.
At the inspection we observed and spoke with three people who used the service at their own home. We spoke with the registered manager and four support staff. We also made phone calls following the inspection to three people who used the service and six relatives.
Before we visited the service we checked the information we held about this location and the service provider, for example, we looked at the inspection history, provider information report, safeguarding notifications and complaints. We also contacted the local authority who commissions the service.
Prior to the inspection we contacted the local Healthwatch who is the local consumer champion for health and social support services. They give consumers a voice by collecting their views, concerns and compliments through their engagement work.
During our inspection we observed how staff interacted with people who used the service and with each other. We spent time observing the care delivered at the service to see whether people had positive experiences. This included looking at the support that was given by the staff, and observing practices and interactions between staff and people who used the service.
We also reviewed records including, three staff recruitment files, three medicine records, safety certificates, four support plans and records, three staff training records and other records relating to the management of the service such as audits, surveys, minutes of meetings and policies.
Updated
9 February 2018
The inspection took place on 3 January 2018. The inspection was announced. We gave the service 24 hours notice of the inspection visit because the location provides a domiciliary care service for younger adults who are often out during the day. We needed to be sure that they would be in.
Walsingham Supported Living was last inspected by CQC on 18 and 19 November 2015 and was rated ‘good’ overall and in all areas. At this inspection we found the service remained Good overall and in all areas.
Walsingham Supported Living is a domiciliary care agency. This service provides care and support to 19 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.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We visited three people in their own home and the atmosphere was very homely, warm and welcoming. People who used the service were relaxed in their own home environment and had a good rapport with their support staff.
People were supported to have choice and control over their own lives from being supported by person centred care approaches. Person centred care is when the person is central to their support and their preferences are respected.
People were supported to forward plan and were also supported to achieve personal goals in their lives.
People were always respected by staff and treated with kindness. We saw staff being respectful, considerate and communicating exceptionally well with people who used limited words to communicate.
People’s support plans were in an easy read format and were person centred. They included a ‘one page profile’ that referenced people’s personal histories and described their individual support needs. These were regularly reviewed.
People were supported to play an active role within their local community by making regular use of local resources including the local shops, social clubs and local activities.
Support plans contained person centred risk assessments. These identified risks and described the measures to be taken to ensure people were protected from the risk of harm. This supported people do the things they wanted to live their lives fully. The support plans we viewed showed us that people’s health was monitored and referrals were made to other health support professionals where necessary.
Staff understood safeguarding issues and procedures were in place to minimise the risk of abuse occurring. Where concerns had been raised we saw they had been referred to the relevant safeguarding department for investigation. Robust recruitment processes were in place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Where people lacked the mental capacity to make decisions about aspects of their care, staff were guided by the principles of the Mental Capacity Act to make decisions in the person’s best interests. For those people that did not always have capacity, mental capacity assessments and best interests decisions had been completed for them. Records of best interests decisions showed involvement from people’s family and staff.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. The service was truly reflective of what people liked and people were in control of this and chose what they would like to eat.
Medicines were stored, managed and administered safely.
Infection control measures were in place for staff to protect people from the risk of infection through cleanliness and protective clothing.
People were supported to exercise their rights and regular access to advocacy services and engagement (have your say) opportunities were available.
People were supported to maintain their independence on a daily basis.
Support staff told us they felt supported to carry out their role and to develop further and that the registered manager was supportive and always approachable.
Staff were trained in equality and diversity were also able to maintain and develop their skills through further training and development.
People were supported by enough staff to meet their needs and also individually with one to one support.
Medicines were stored, managed and administered safely. We looked at how records were kept and spoke with the registered manager about how support staff were trained to administer medicines and how this was monitored.
We found an effective quality assurance survey took place regularly and we looked at the results. The service delivered had been regularly reviewed through a range of internal audits.
We found people who used the service and their representatives were regularly asked for their views about the support and service they received.
People and their relatives were able to complain if they wished and were knowledgeable of how to complain or raise minor concerns.
The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.