Supported Futures

Updated 6 September 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 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 was not a registered manager in post. A manager had been in post for over 12 months. However they had not submitted their application to register with us. During the inspection, the manager started the application process. Once submitted we will assess their application.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or the manager would be in the office to support the inspection.

Inspection activity started on 27 July 2023 and ended on 10 August 2023. We visited the location’s office on 08 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 2 people's relatives regarding their experiences of the care provided. We spoke with 5 members of staff including support workers and the manager.

We reviewed a range of records. This included 2 people's care records and medication records. We looked at 3 staff files in relation to safe recruitment. A variety of records relating to the management of the service were reviewed, including policies and procedures.

Updated 6 September 2023

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.

About the service

Supported Futures is a domiciliary care agency offering personal care and support to children and adults living within their own homes. The service supports autistic people and people with a learning disability. 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 this inspection, 2 people were receiving personal care.

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

Right Support:

Relatives told us people felt safe and respected by the staff who supported them. However, systems and processes required improvement to ensure care practices were documented and to evidence risks were being managed safely.

Staff were recruited safely and received training and development opportunities. However, there were gaps in training and some training courses had expired.

Incidents of distressed behaviour were documented. However, follow up processes and incident analysis needed improving to ensure people were given the appropriate support after an incident involving distressed behaviour.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the systems in use did not always record this practice. Care plans needed improving to ensure they clearly documented how the provider was working in line with the Mental Capacity Act.

People were supported safely by dedicated and compassionate staff, who knew them well. Relatives told us they knew and trusted the staff team.

Right Care:

The provider worked in partnership with people, relatives and outside agencies to provide appropriate level of care and support. However, further improvement was needed to document partnership working and record this within care and support plans.

Care plans were person centred and people were supported to take positive risks. People were encouraged to try new activities, to make their own decisions and develop daily living skills.

Safeguarding policies were regularly updated and included in a staff induction booklet. Staff told us how they protect people from potential abuse, and they were confident about reporting concerns.

Right Culture:

The culture of care and support was person centred and focused on the individuality of people. However, quality processes required improvement to ensure risks were monitored and care practices were regularly audited.

There was a culture of learning when things went wrong. All improvements identified during the inspection were acted upon quickly and openly.

The manager understood their duty of candour and was transparent throughout the inspection and made improvements to the processes and systems in place. These will be reviewed in the next inspection.

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 (published 14 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received relating to an absence of a registered manager over a significant period of time and concerns received about staff training. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We inspected and found there was a concern with Mental Capacity Act documentation in care plans, so we widened the scope of the inspection to include the key question of Effective.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can see what action we have asked the provider to take at the end of this full report.

The provider acted on all concerns raised and implemented new process and systems to address these concerns. We will review the success of the new systems in the next inspection.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Supported Futures on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the overall governance of the service at this inspection.

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.