Background to this inspection
Updated
23 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.
This inspection took place on 20 February 2018 and was announced. The provider was given 48 hours’ notice because the location was a service for people who are often out during the day; we needed to be sure that someone would be in. The inspection team consisted of one adult social care inspector, a CQC pharmacy inspector and an expert by experience that made telephone calls to people and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed other information we held about the service, including any statutory notifications we had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. Before the inspection, we also contacted the local authority commissioners for the service and the local authority safeguarding team to gain their views of the service provided.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We looked at two care records for people who used the service. We examined three sets of staff files which covered recruitment, supervision and training records and various records about how the service was managed.
People who used the service were unable to communicate with us verbally. We spoke to two relatives over the telephone, the registered manager, service director, project manager and 2 staff members. We visited two services to check their medicine records. Due to staff living far away from the office we provided them with a questionnaire so they could provide their points of view. We received four questionnaires back.
Updated
23 March 2018
This inspection took place on 20 February 2018 and was announced.
This service provides care and support to four people living in three ‘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.
The service had a registered manager in post. 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.
At the last inspection in December 2015, the service was rated Good. At this inspection we found the service remained Good.
Risks were well managed. People were encouraged to be independent and to take everyday risks. Risk assessments were in place to cover various aspects of people’s daily lives, which included guidance for staff on how to manage identified risks.
Relatives told us they were happy with the service provided. Sufficient experienced and trained staff were deployed to ensure people’s needs were met. The provider was in the process of recruiting new staff to maintain this. People were supported by staff that were trained to carry out their roles effectively. Staff received mandatory training as well as training which was tailored to the needs of those they supported. All staff received an induction and an on-going programme of supervision and appraisal. Staff felt supported.
Staff were knowledgeable about the people they supported, their likes and dislikes and interests.
Appropriate arrangements were in place for the safe administration and storage of medicines. We have made a recommendation about the recording of when required (PRN) medicines.
Systems were in place, and had been followed to reduce any risks of abuse and harm. Staff told us they would be confident to raise any concerns they had and they would be acted upon. An effective recruitment and selection process was in place. The provider carried out monthly health and safety checks to ensure people lived in a safe environment.
Accidents and incidents, although very few, were accurately recorded and reported and any lessons learned were shared with staff.
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.
People's rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role.
Relatives and people were involved in the planning of their care. Information was provided in easy read format to assist people in understanding the care available to them. The provider had an effective complaints procedure in place and relatives were aware of how to make a complaint.
People were supported in maintaining a healthy and balanced diet. People were involved in the preparation of meals. People were supported to maintain good health and had access to health and social external professionals.
Activities were developed around people’s interests. People were supported to maintain relationships and access the local community.
Although staff felt supported by colleagues they said they felt undervalued be higher management and morale was just okay.
The provider understood the importance of monitoring the quality of the service and reviewing systems to identify any lessons learnt. The service consulted with people, relatives and staff to capture their views about the service.