Zeno Limited

Updated 5 October 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 6 inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in ‘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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were 4 registered managers in post with collective responsibility for the service.

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.

Inspection activity started on 9 August 2023 and ended on 18 August 2023. We visited the location’s office on 9 August 2023 and over the course of the inspection we visited 9 supported living houses.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, and we sought feedback from the local authority in relation to the concerns received. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person (who consented to speak with us) in their own home and we spoke with 7 people’s relatives. We also spoke with 14 members of staff, including, 2 registered managers, head of HR, the risk and quality manager, the development lead, 2 deputy managers, a service manager and care and support staff.

We reviewed a range of records. This included 8 people’s care records and various medication records. We looked at 5 staff files in relation to recruitment. We also viewed a variety of records relating to the management of the service including training records and policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 5 October 2023

About the service

Zeno Limited is registered to provide personal care services to people in their own homes or supported living. People the service supports have a range of needs including learning disability, autism and complex needs.

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. At the time of the inspection there were 57 people receiving personal care which was overseen by 4 registered managers across 19 supported living houses.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were not always supported to have maximum choice and control of their lives and staff were not supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people's best interests. People were not always protected from the risk of harm; we identified several potential environmental hazards. People were able to choose how they spent their time and were supported by staff to take part in activities and pursue their interests in their local area or access to the providers outreach college. We found 2 staff employed had not had all the required checks completed for working with vulnerable people, gaps in their employment histories were not always explored. There were enough staff available to provide care and support to people as they needed it and in the event of an emergency.

Right Care:

The ethos and values of the provider was not always embedded in care delivery. We visited the different supported living settings and were concerned to see aspects of people’s environments did not uphold their dignity or meet the values of the right support, right care and right culture. People's care and support plans were reflective of their range of needs. Staff spoke to people in a dignified and respectful way, and it was clear from what we were told that people and staff had developed good relationships.

Right Culture:

The provider had not always ensured that the safety and quality of the service had been effectively assessed. The registered provider responded quickly to the concerns we identified on inspection; however, it was acknowledged the existing systems and processes in place were not providing them with effective oversight of the service.

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 (1 February 2019)

Why we inspected

The inspection was also prompted in part due to concerns received about the service. A decision was made for us to inspect and examine those risks.

Enforcement and Recommendations

At this inspection, we have identified breaches in relation to failings in how the provider monitored the safety of the service, a failure to ensure all restrictions were considered in line with the mental capacity act and with good governance due to the provider failing to monitor the quality and safety of the service.

We have made a recommendation about ensuring all of the required checks are made during the recruitment of staff and assessing the service using the principles of Right Support, Right Care, Right Culture.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.