Background to this inspection
Updated
30 October 2015
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 30 and 31 June 2015. The provider was given 48 hours’ notice because the location provides a supported living service and we wanted to ensure the registered manager would be there.
The inspection was carried out by one inspector. Prior to the inspection we reviewed the records we held about the service, including the details of any safeguarding events and statutory notifications sent by the provider. Statutory notifications are reports of important events that the provider is required by law to inform us about.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help us plan the inspection.
Prior to this inspection we contacted two local authority representatives from commissioning and the community learning disability team and received feedback from one of them about the service.
During the inspection we spoke with three staff, the registered manager and deputy manager. We visited the four people receiving the regulated activity of personal care in their homes and spoke with them about the support they received. Following the inspection we spoke in more depth with a group of six staff two of whom we had met briefly during the inspection.
We reviewed the care plans and associated records for three people, including risk assessments and reviews and related this to the care observed. We examined a sample of other records to do with the operation of the service including staff recruitment, training, and supervision records, complaints, and various monitoring and audit tools.
Updated
30 October 2015
The inspection took place on 30 and 31 July 2015, we gave the registered manager short notice of our inspection to ensure that the office was staffed when we arrived, and to make arrangements for us to meet people using the service. This supported living service supports four people with the regulated activity of ‘personal care’. Two of whom shared one house, and the other two people shared another house. The people supported all had needs relating to their learning disability.
External stakeholders held this service in high regard and stated that it was well led, provided an excellent standard of support to people, and was a role model for this type of service. People were able to tell us about living in the service but not everyone was able to speak in any depth about their experiences of support. They told us that there were always staff around to support them and this made them feel safe. They said that staff supported them to access the community and do the things they wanted to do.
The service was required to have a registered manager and one was in place. 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.
We found the service was well managed and people received their medicines safely but we found one example where medicine administration times were undated and unsigned, and this was discussed with the registered manager who took immediate action to rectify this. The Recruitment of new staff ensured that all relevant checks were undertaken before they commenced the support of people, but discussions with applicants about any gaps in their employment histories had not been routinely recorded.
Care plans were personalised, up to date and accurately reflected people’s care and support needs. They included information about people’s ‘likes’, ‘dislikes’, interests and background and guided staff in provided the appropriate level of support.
We observed staff interactions with people to show warmth, humour, patience, kindness and respect, and people and staff were observed chatting and laughing together.
People were cared for by an established and, motivated staff team. There were enough staff available to flexibly support people’s individual needs. They were well trained and showed they understood how to meet people’s specific health, care and treatment needs.
Staff in the service were working to the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The registered manager and staff had received training around this legislation and how it should be interpreted in their daily support and practice. No one receiving the regulated activity of personal care was subject to an order of the Court of Protection, or had a lasting Power of Attorney in place. People were protected from decisions being taken without their involvement because staff showed they understood the actions to take to assess people’s capacity and seek the involvement of others to make best interest decisions on the person’s behalf.
The registered manager and the Company directors provided effective leadership to the service.
They had a visible presence within the service and monitored the quality of its operation. The views of staff and people were sought and acted upon. Relatives and external professionals were kept informed about people’s individual progress
Staff were knowledgeable about people, understood their communication and were effective in meeting their needs. Staff respected people’s dignity, privacy and rights; and advocated on their behalf with other agencies. Staff also ensured people’s healthcare needs were met. People were actively involved with the local community and staff supported them to engage in a wide variety of activities and interests in the community.
The registered provider and staff were actively participating in research conducted by the Tizard Centre, Canterbury, and was a member of organisations promoting good practice in the delivery of support to people with learning disabilities, such as Kent Challenging Behaviour Network, and Paradigm.
We have made an improvement recommendation in relation to staff recruitment records:
The provider should ensure that staff recruitment records contain the information specified in regard to gaps in employment histories as required under regulation 19 (3) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.