Background to this inspection
Updated
12 November 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Inshore Support - 88 Broad Street is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the provider a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be available to support the inspection and there would be people at home to speak with us.
What we did before the inspection
Prior to the inspection, we reviewed the information we had received about the service since the last inspection and sought feedback from local authority commissioners for the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.
During the inspection.
We saw how staff supported the people they cared for and talked with one person who lived at the home. We spoke with a relative, the manager, a director of care and one agency care staff.
We looked at a range of documents and records including one person’s care records, two communication passports, medication records, menus, and activities people enjoyed. We also reviewed systems for managing complaints and how the provider and manager monitored the quality of the service provided.
After the inspection
We continued to seek clarification from the provider to validate evidence found, such as training data and recruitment checks.
Updated
12 November 2019
About the service
Inshore Support – 88 Broad Street provides accommodation for up to four people living with a learning disability or autistic spectrum disorder. At the time of our inspection there were two people living in the home. One person was at the home on the day of our inspection visit, one person was in hospital. To protect people’s rights to a private life, the report will provide an overview of people’s experiences of living at the home.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the managers at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
People’s experience of using this service and what we found
The service did not have a registered manager. Since the last inspection the registered manager had left the service. The provider had employed a new manager who was in the process of applying to register with us.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
There were enough staff to keep people safe and to meet their needs. Staff understood their responsibility to safeguard people from harm and how to manage identified risks to people’s care. People received their medicines as prescribed and recruitment checks made sure staff were of suitable character to work with vulnerable people.
Staff received training and support to carry out their roles effectively. Staff knew people well, but recent staff changes had meant less consistency of staff for people living in the home. Regular agency staff were being used which provided continuity while recruitment of permanent staff was taking place.
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 supported this practice.
Staff encouraged people to maintain a balanced diet and respected their individual choices. The manager and staff worked with healthcare professionals to ensure people's health and wellbeing was maintained.
Staff and managers were caring and spoke positively about the people living in the home. People were comfortable within the home, they enjoyed spending time with the managers and staff and were able to follow their hobbies and interests.
People’s plans were personalised. Staff had time to read plans and were kept up to date about people’s care and support. People were involved in the running of the home and were provided with opportunities and information about making complaints.
Quality checks were carried out by the provider and manager to monitor the service, which identified where improvements could be made. The manager told us the lack of senior staff had restricted their availability to carry out quality assurance effectively.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was rated as Good (published 24 June 2017).
Why we inspected
This was a planned inspection based on the date and previous rating of the last inspection.