Archived: MacIntyre Hampshire Supported Living

Updated 30 October 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 checked 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 comprehensive inspection took place on 19 and 20 September 2018 and was carried out by one inspector. The inspection was announced which, means that we gave the provider 48 hours' notice of the inspection to ensure key staff were available to speak with us. On 19 September 2018 we completed a site visit at the service registered office then followed this with visits to three supported living settings later that day and on 20 September 2018.

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 reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information contained within the provider's website.

During our inspection we spoke with 12 people using the service, some of whom had limited verbal communication, and two relatives. We used a range of different methods to help us understand the experiences of people using the service, who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process which enables us to look in detail at the care received by an individual in the home. We pathway tracked the care of six people.

Throughout the inspection we observed how staff interacted and cared for people across the course of the day, including mealtimes, during activities and when medicines were administered. We spoke with the registered manager, three heads of service, two deputy heads of service, two office administrators, a project start up manager, the service audit and standards officer, and twelve staff, including four seniors and one agency staff. We spoke with three health and social care professionals who supported the service.

We reviewed 12 people’s care records, which included their daily notes, care plans and medicine administration records (MARs). We looked at ten staff recruitment, supervision and training files. We examined the provider’s records which demonstrated how people’s care reviews, staff supervisions, appraisals and required training were arranged.

We also looked at the provider’s policies and procedures and other records relating to the management of the service, such as staff rotas covering August and September 2018, health and safety audits, medicine management audits, infection control audits, service improvement plans, emergency contingency plans and minutes of staff meetings. We considered how people’s, relatives and staff comments were used to drive improvements in the service.

This was the first inspection since the service changed its legal entity in July 2017.

Updated 30 October 2018

This announced inspection took place on 19 and 20 September 2018 and was carried out by one inspector.

MacIntyre Hampshire Supported Living provides care and support to people living in 15 different 'supported living' settings, 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.

At the time of the inspection the service was supporting 37 people with their personal care needs. The service supported people living with learning disabilities, autistic spectrum disorder, physical disability, sensory impairment, older people and younger adults. The levels of support provided varied. Some people had complex health and social care needs and required 24-hour care, whilst others received support from an outreach service.

At the time of the inspection the service had a registered manager. 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 registered manager was supported by seven front line managers who were referred to as heads of service.

People were consistently protected from avoidable harm, neglect, abuse and discrimination. Staff ensured the human rights of people who lacked a voice, were upheld and respected.

Risks to people's safety had been identified and management plans gave staff the required guidance to mitigate these risks. Staff delivered safe care in line with people’s risk assessments.

Regular staffing needs analyses ensured there were always enough suitable staff deployed, with the right mix of skills to deliver care and support to meet people’s needs safely. Staff underwent robust pre- employment checks to assess their suitability to support people using the service.

People received their prescribed medicines consistently and safely, from staff who had been trained and had their competency to do so assessed regularly. Staff supported people to maintain high standards of cleanliness and hygiene in their homes, which reduced the risk of infection.

The provider enabled staff to develop and maintain the required skills to meet people’s needs. Staff applied their learning effectively in accordance with best practice, which led to good outcomes for people’s care and support and promoted their quality of life.

People were supported to have enough to eat and drink to protect them from the risks associated with malnutrition. Where required people were supported to eat and drink safely to avoid the risk of choking. Staff understood the importance of food safety and prepared and handled food in accordance with required standards.

The service had clear systems and processes for referring people to external healthcare services, which were applied consistently, and had a clear strategy to maintain continuity of care and support when people transferred services.

People and relatives were involved in decisions about their health and encouraged to make choices, in line with best interest decision-making. People’s human rights were consistently protected by staff who understood the need to seek lawful consent and followed the Mental Capacity Act 2005 (MCA) legislation and guidance.

People were treated with kindness and compassion by staff who supported people to express their views and be actively involved in making decisions about their care as far as possible. Staff noticed when people were in discomfort or distress and took swift action to provide the necessary care and reassurance. People were consistently treated with dignity and respect and without discrimination.

People had the opportunity to give feedback about their experiences and knew how to raise any concerns or make a complaint. The registered manager used the learning from complaints and concerns to drive improvement in the service.

Staff sought accessible ways to communicate with people when their protected and other characteristics under the Equality Act made this necessary to reduce or remove barriers. People’s protected characteristics were taken into consideration when developing their care plans.

People were provided with the opportunity to discuss and record any advanced decisions and end of life wishes.

The service was consistently well-managed and led. The provider had a clear vision for all people with a learning disability to live a life that makes sense to them, an ethos which staff had embraced in their day to day care delivery.

Quality assurance arrangements were robust and identified potential concerns and areas for improvement. The provider’s systems effectively managed identified risks to the quality of the service.

The registered manager and staff had a clear understanding of equality, diversity and human rights, and they prioritised safe, high-quality, compassionate care.

The service had a collaborative approach to working with other stakeholders and organisations to improve care practice and outcomes.