Background to this inspection
Updated
22 June 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 team consisted of one inspector.
Service and service type
This service provides care and support to people living in 2 ‘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 not required to have a registered manager. The provider is required to oversee the delivery of regulated activities at this location.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 15 March 2023 and ended on 24 March 2023. We visited the location’s office on 15 March 2023.
What we did before inspection
We used information gathered as part of a monitoring activity that took place on 23 August 2022 to help plan the inspection and inform our judgements. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
During the inspection we spoke with the provider, two members of staff and two people who used the service. Following the inspection, we telephoned a relative of a person who used the service.
We looked at the care plans for two people who use the service. We also looked at multiple medication administration records and other records relating to the management of the service.
Updated
22 June 2023
About the service
The Old Post Office is a domiciliary care agency providing personal care to people in supported living accommodation. The service provides support to autistic people and people with a learning disability. At the time of our inspection there were 4 people using the service.
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 everyone using the service was receiving personal care.
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 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; the policies and systems in the service did not support this practice. While staff supported people to make their own decisions and did not place unnecessary restrictions on people, this information had not been fully documented.
Systems to manage medicines did not always follow best practice and increased the risk of errors.
People were encouraged to take part in a wide range of activities and to maintain relationships with friends and family.
People’s health needs were supported, and staff worked with healthcare professionals to ensure people received the care they needed.
Right Care:
Risks to people were not fully assessed and care was not planned to keep people safe from harm.
Staff had not received all the training they needed to ensure they could provide safe care to people.
The service had enough staff to meet people’s needs. However, safe recruitment processes had not been followed to ensure staff were safe to work with people using the service. There was no training plan in place to ensure staff had the skills needed to provide safe care.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Right Culture:
The provider had failed to monitor the quality of the service provided which led to shortfalls in the service. However, they were responsive to the concerns raised and wanted to improve. They took immediate action to rectify the issues we found. This included reviewing staff training, risk assessments and recruitment processes.
Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff placed people’s wishes, needs and rights at the heart of everything they did.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 4 March 2021, and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches in relation to managing risks, the safe management of medicines, lack of staff training and unsafe recruitment of staff and inadequate systems to monitor the quality of care provided 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.