Archived: Next Stage ‘A Way Forward’ North East

Updated 20 March 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.

The inspection was carried out due to reported concerns about the safety of people who used the service.

This inspection took place on 28 November and 29 November 2017 and was unannounced. The inspection team consisted of two adult social care inspectors.

Before the inspection we reviewed information we held about the service as part of our inspection. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send CQC within required timescales. We contacted commissioners from the local authorities who contracted people's care. We spoke with the local safeguarding team.

During the inspection we spoke with four people who were supported by Next Stage A Way Forward North East, the registered manager, five support workers and three visiting professionals who visited the service during the inspection. We reviewed a range of records about people’s care and how the service was managed. We looked at care records for four people, recruitment, training and induction records for three staff, three people’s medicines records, staffing rosters, staff meeting minutes, meeting minutes for people who used the service and quality assurance audits the registered manager had completed.

Updated 20 March 2018

This was an unannounced inspection carried out on 28 November 2017.

This was the first inspection of Next Stage A Way Forward North East since it was registered with the Care Quality Commission in March 2017.

Next Stage a Way Forward is registered to provide personal care. The care service had 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 using the service can live as ordinary a life as any citizen. People using the service lived in their own flat. A separate office was also available on-site to manage the supported living arrangements and there was a staff presence over twenty four hours.

A separate office off-site was registered to provide the domiciliary service. The service also provides care and support to people living in a ‘supported living’ setting, so that 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.

A registered manager 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 three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This related to safe care and treatment, staff training and governance.

People told us they felt safe and were well cared for. However, systems were not in place to keep people safe and to provide consistent care to people. Strategies were not in place to support distressed behaviours effectively. Risk was not well-managed. There were sufficient staff to meet the allocated care provision of people.

Improvements were required to staff training and the safe handling of medicines to ensure people received safe and effective care.

People were encouraged to follow a healthy and nutritional diet. Although staff were caring an understanding of professional boundaries was not in place for all staff. People’s privacy and dignity were respected. People were able to make choices about aspects of their daily lives. They 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.

People were supported to be part of the local community. Improvements were needed to the social aspects of people’s lives to support them to lead more fulfilled lives with the provision of a range of opportunities to follow new interests and hobbies and the encouragement of work or college placements.

People had some opportunities to give their views about the service. There was regular consultation with people. People had access to an advocate if required.

A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to.

Staff and people who used the service told us the registered manager was supportive and approachable. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Improvements had been made to communication within the service.

A robust quality assurance system was not in place to assess the quality of the service. Audits that were required were not all carried out and some that were carried out were not effective as they had not identified issues that we found at inspection.

You can see what action we told the provider to take at the back of the full version of the report.