Background to this inspection
Updated
6 January 2024
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 undertaken by 4 inspectors. A regulatory coordinator made telephone calls to staff. An Expert by Experience sought feedback from people’s 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.
Service and service type
This service provides care and support to people living in 6 ‘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 was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection because the service has properties in several locations. We also required the provider to seek people’s consent to enter their homes.
What we did before the inspection
We reviewed information received from and about the service since the last inspection. We sought feedback from the local authority. 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 used the service and 3 relatives about their experience of the care and support. We spoke with 11 members of staff including support workers, service manager, registered manager, the head of operations and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We visited 2 properties where people received a regulated activity and viewed people’s flats with their consent. We received feedback from 3 professionals who worked with the service.
We reviewed a range of records including 4 people’s care plans, medication records and 2 staff files in relation to recruitment and supervision. We viewed a variety of records relating to the running of the service, including policies and procedures. We used technology including electronic file sharing to enable us to review additional documentation following our site visits.
Updated
6 January 2024
About the service
Heathcotes Yorkshire Supported Living Office provides care and support to people living in their own home with the aim of maximising people’s independence. People lived within 1 of 6 supported living properties. The service provides support to older and younger adults who may be living with mental health needs, a learning disability or autism.
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, the service supported 4 people with a regulated activity across 2 properties.
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 did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support this practice. Records were not consistently available to show the service had worked within the principles of the Mental Capacity Act (2005). The provider failed to demonstrate how they were promoting elements of best practice at this service.
Right Care
Staff training was not always completed or up to date to ensure staff had the skills and knowledge needed, which could have compromised people’s safety. The provider did not operate a robust system to review accidents and incidents to consider learning or improvements. Person-centred information was available to guide staff and staff knew the people they supported well. Staff spoke about and with people in a respectful manner and promoted their dignity. People had access to healthcare professionals and information was available about how to monitor and respond to any changes in their health.
Right Culture
There were continued issues with the oversight and management of the service which compromised the quality and safety of the service. Audits had not been used effectively to identify and drive improvements. There had not been sufficient improvement since the last inspection. A high turnover of managers within the supported living settings affected the stability of the service and did aid establishing trusting relationships with people. We received mixed feedback about the service, with some people stating the care had been ineffective and unsafe and this had impacted on people’s health and well-being. Others praised the service and the positive impact the staff had made. Limited feedback was sought from people to understand their experience of the service and consider how this could be improved.
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 requires improvement (published 07 February 2023). At this inspection we found the provider to be in breach of regulations and the service remains rated requires improvement. The service has been rated requires improvement or inadequate for the last 3 inspections.
At our last inspection we recommended the provider seek advice from a reputable source about guidance for ‘as and when needed’ medicines, how to support people with their fluid intake and the principles of the MCA including understanding of least restrictive practice. At this inspection we found the provider had not fully acted on these recommendations or made sufficient improvements.
Why we inspected
We received concerns in relation to the staff culture and safety of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. You can see what action we have asked the provider to take at the end of this full report. Since our inspection, the provider has started to take action to mitigate risks to people
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathcotes Yorkshire Supported Living on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to consent, safe care and treatment and governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.