London Borough of Merton - Supported Living Service

The providers of housing are Wandle Housing, Clarion Housing Group and Evolve Housing.

London Borough of Merton Supported Living Scheme provides support to people of all ages with learning and/or a physical disabilities and mental health concerns who live in their own individual flats. At the time of our inspection the provider was supporting 39 people who lived in five different supported living settings in the Borough.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The supported living service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include the promotion of choice, independence and inclusion, so people with learning disabilities and autism can live as ordinary a life as any citizen.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were safe in their homes. Staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. Recruitment practices were safe and there were sufficient staff to meet people’s needs. Staff were trained in medicine administration and the checks we made confirmed that people were supported to receive their medicines in a way that they had agreed. Effective measures were taken to help prevent and control infection.

People were supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people's needs.

People 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.

When required people were supported to prepare meals to meet their nutritional needs. When required staff worked with people's GP and other healthcare professionals to ensure they stayed well and comfortable.

People told us staff respected their privacy and treated them with dignity. People's needs were assessed before they started to use the service and care was planned and delivered in response to their needs. The provider had arrangements in place to respond appropriately to people's concerns and complaints. Systems were in place to support people with their end of life care when needed.

Systems were in place to monitor and improve the quality of the service. The provider had effective quality assurance systems to monitor the scheme's processes. These systems helped ensure people received the care they needed as detailed in their support plans.

The registered manager had a clear understanding of their management role and responsibilities and the provider's legal obligations towards CQC. The registered manager worked effectively with other organisations to ensure staff followed best practice. The service had good links with other resources and organisations in the local community to support people with their needs.

London Borough of Merton Supported Living Service provides personal care and support to people living in five supported living schemes within the borough. The service also provides floating support to people living in their home which is intended to help them to live independently. The service specialises in providing care and support to adults with learning disabilities, physical disabilities, mental health conditions and substance misuse problems. At the time of this inspection there were 31 people being supported by the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People said they were safe when being supported by staff. Staff knew how to ensure people were protected if they suspected they were at risk of abuse or harm. Staff discussed with people the risks they faced at home and in the community and how they could stay safe. Staff were given appropriate guidance on how to support people to minimise identified risks to keep them safe from harm or injury in their home and community.

People said staff were accessible and available when they needed them. The provider ensured staff were suitable and fit to work at the service by carrying out employment and criminal records checks before they could start work. Staff received appropriate training and support from senior staff to help them to meet people’s needs. They were set objectives linked to people’s personal aspirations for independent living. Progress against objectives were checked by senior staff through supervision and appraisal.

People were supported to make decisions and choices about their care and support needs. Their support plans reflected their specific needs and preferences for how they wished to be supported to build and maintain the skills they needed for independent living. These were reviewed regularly by staff who checked for any changes to people’s needs. Staff knew people well and what was important to them in terms of their needs, wishes and preferences.

Staff monitored people’s general health and wellbeing. People were supported to take their medicines as prescribed. When staff had any issues or concerns they sought appropriate medical care and attention promptly from other healthcare professionals. Staff supported people to make healthy lifestyle choices. People were encouraged to eat and drink sufficient amounts to reduce the risk to them of malnutrition and dehydration.

People spoke positively about the staff that supported them. Interactions between people and staff were warm and friendly. Staff dealt with people’s queries in a patient, respectful and appropriate way. Staff respected people’s right to privacy and to be treated with dignity. People were encouraged to take part in activities and interests at home or out in the community, to go to work and to maintain social relationships that were important to them.

People were satisfied with the support they received from staff. They said they felt comfortable raising any issues or concerns with staff. The provider had arrangements in place to deal with people’s complaints appropriately.

People and staff were asked for their views about the quality of care and support provided and how this could be improved. They said senior staff were approachable, accessible and supportive. Senior staff monitored the quality of care and support provided. They analysed results from questionnaires, carried out visits and undertook audits of the service. Staff took appropriate action if any shortfalls or issues were identified through checks and audits.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff were aware of their roles and responsibilities in relation to the Act.

People told us staff talked to them and asked them how they wanted to be cared for. We checked people's personal records and saw people using the service and where appropriate their friends and families were involved in planning and reviewing their care and support needs. We also saw people were asked for their views and experiences as well as their suggestions for improvements through questionnaires and residents meetings.

Each person using the service had an individualised support plan. From conversations we had with people using the service and members of staff we found people received the care and support that had been planned. Staff members we spoke with demonstrated good awareness and understanding of the care and support needs of people they looked after. From staff records we saw staff received appropriate training and development to keep their skills and knowledge up to date. This made them better equipped to meet the needs of people they looked after.

Staff were provided with guidance and instructions about what they should do to protect people who may be at risk of abuse, harm or neglect. Staff were able to tell us what actions they would take if they had any concerns about a person using the service. People we spoke with told us they felt safe in their home.

People were also asked for their views and given opportunities to make suggestions for improvements. We saw the service acted on these suggestions appropriately. Senior staff carried out checks to ensure that people's care and support needs were met in accommodation that was suitable and safe.