This inspection took place on 4 and 12 May 2016 and was announced. We announced the inspection 24 hours prior to calling. This was to ensure that people would be at home on the day that we visited. A previous inspection undertaken in November 2013 found there were no breaches of legal requirements.Northumberland Supported Living Service is based at Sea Lodge, Cresswell. The service provides personal care and support to two people with severe learning disabilities. The location is rented by the two people from a housing association, who are responsible for the majority of the upkeep and maintenance of the property. Each individual has access to their own bedroom, conservatory/ lounge area, bathroom and garden area. There is a shared kitchen and dining area.
The service had a registered manager who had been registered since July 2011. 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 provider had in place a safeguarding policy and staff had received training in relation to the safeguarding of vulnerable adults. They said they would report any concerns to the manager or senior staff. There had been no safeguarding incidents in the service in the previous 12 months. Risk assessments were in place regarding the general operation of the service and also linked to the care delivery for each person living at the home. Regular checks were maintained on the safety of the premises and equipment.
Staffing numbers were maintained at a level that ensured the safety of people who used the service and to deliver individualised care. Proper recruitment procedures and checks were in place to ensure staff employed by the service had the correct skills and experience. Medicines were stored and handled correctly and safely. There were plans in place for the use of “as required” medicines and the use of covert medicines, where necessary.
People were supported to access adequate levels of food and drink. Staff supported people to develop simple cooking skills. People were also supported to visit outside establishments for meals and snacks. Where professionals had given advice or guidance about people’s diet we saw that this was being followed.
Systems were in place to ensure staff had regular training and updating of skills and staff confirmed this was the case. Records indicated that the majority of staff had completed all mandatory training. Staff told us, and records confirmed there were regular supervision sessions for all staff members and each staff member had an annual appraisal.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’ it also ensures unlawful restrictions are not placed on people in care homes and hospitals. Where necessary applications had been made to the Court of Protection to ensure people’s interest were protected. Staff were aware of the need for best interests meetings to take place where decisions needed to be made and people did not have capacity to make their own decisions. Where necessary best interests decisions had been undertaken and recorded.
The home had been adapted to promote people’s independence with easy access to a range of facilities, with the support of the service provider. The decoration was plain in some areas, but staff said they needed to introduce changes carefully.
We observed staff treated people with great patience and kindness and showed a genuine interest in them as individuals and a real concern for their welfare. Staff understood about people’s individual needs and personalities. People’s cultural and religious needs were actively supported and encouraged. People had access to health care professionals to help maintain their wellbeing. Specialist advice was sought and acted upon, where necessary. There was evidence in meeting records that staff advocated on behalf of people. Staff understood about treating people with respect and dignity and put this into practice.
People’s needs had been fully assessed and individualised care plans and risk assessments developed that addressed all their identified needs. Care records and care plans were reviewed in multiple ways to ensure they met individual’s needs and potential changes were identified as soon possible. People had access to highly individual activities based around their likes and dislikes. The registered manager told us there had been no formal complaints in the last year. We saw the service had received several compliments and positive comments about the care.
The registered manager showed us records confirming regular checks and audits were carried out by the service. Staff were positive about the management of the service. They said there was a good staff team who felt well supported by colleagues. They said they enjoyed working in the service and supporting people.
The service had links to a local university and accepted student nurses on training and also providing teaching for the course. Records at the service were complete and contained good detail.