Background to this inspection
Updated
31 August 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one adult social care inspector.
Service and service type
The service provides care and support to people living in a number of ‘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 manager in place who was in the process of being registered with the Care Quality Commission. Therefore, the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service about their experience of the care provided. We spoke with five members of staff and the manager.
We reviewed a range of records. This included four people’s care records and medicine records. We looked at four staff files in relation to recruitment and at the staff supervision records. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
31 August 2019
About the service
Bell’s Piece Supported Living Service provides support to people living in their own homes. At the time of the inspection they were providing personal care and support to nine people. People who live in supported living properties have individual tenancy agreements. Some people lived in flats on a site that held the main office and had a residential home and day care facilities. Other people lived in the community.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism.
Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were happy with the service provided. They had positive relationships with staff and said; “I’m happy with the staff.”
People told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. The support required with medicines was assessed, agreed and provided to people. Infection control measures were in place to prevent cross infection. Staff were suitably recruited. People were supported by a consistent staff team and the staffing levels were flexible to enable the service to provide a bespoke service to people.
People were supported by staff who were inducted, trained and supervised. The support required by people with health and nutritional needs was identified and provided. 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.
People confirmed staff were kind and caring. Their privacy and independence were promoted.
Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.
People had person centred care plans in place. They were actively involved in their care and contributed to the development of care plans and reviews. Some people had staff support to access activities and holidays. This was flexible and provided in response to people’s choices. People’s communication needs were identified, and their end of life wishes were explored and recorded.
People were supported by a service that was well managed. The manager has been in post for a short time and is yet to register with the CQC. Records were organised, accessible and up to date. The service was audited, and action taken to address any areas they had identified that needed improving. People and staff were complimentary of the manager and said; “Very approachable” and “Most approachable we’ve had” and “Is really good[staff] will help with any problems we have.” Staff were committed to providing good outcomes for people.
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 3 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
The overall rating for the service remains unchanged and the service is rated good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.