Archived: EMH Supported Living

Updated 17 July 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 team consisted of three inspectors.

Service and service type

This service provides personal care and support to people living a number of ‘supported living’ settings, so that they can live as independently as possible. At the time of our inspection, there were 171 people receiving personal care. 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 manager registered with the Care Quality Commission. This means that they 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

This inspection was announced. We gave six days notice to ensure that key managers and staff were available to speak with us and to give the provider time to obtain people’s consent for us to speak with them in their own homes or by telephone.

What we did before the inspection

Before our inspection we looked at key information we held about the service. This included the Provider’s Information Return (PIR) and any written notifications they had send us since our last inspection. The PIR is information providers are required to send us with key information about their service, what they do well and any improvements they plan to make. Notifications are information about important events, which the provider must tell us about when they happen at the service. This information helps to support inspections. We sought and took account of any feedback from partner agencies involved with people’s care. This included local authority care commissioners who contract with the provider for people’s personal care on their behalf. We used all of this information to plan our inspection.

During the inspection

We spoke with twenty people and two relatives about their experience of the care provided. We spoke with twenty care support staff, including three care co-ordinators; a community inclusion and engagement staff lead, an assistant care manager and a project staff lead. We spoke with the registered manager, the provider’s operations and head of care managers; along with a quality and compliance lead officer for the provider. We also observed how staff interacted with people in their own supported living settings.

We viewed a range of records relating to people’s care the management and running of the service. This included parts of eleven people’s care records; staff training, communication and engagement records; complaints and safeguarding records; the provider’s checks of the quality and safety of people’s care and related improvement plans.

Updated 17 July 2019

About the service

EMH Supported Living provides personal care to people with a learning disability or autistic spectrum disorder, who may also be living with physical disability. People received care in their own private single or multi-occupancy living accommodation via individual private tenancy agreements. At the time of our inspection there were 171 people using the service.

Not everyone who uses 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 consider any wider social care provided.

The service is developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This aims to ensure 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’s experience of using this service and what we found

People’s care was not always personalised. People’s choice, control, independence and inclusion was often ensured in a way that enabled opportunities for them to gain new skills and become independent. Targeted management and staffing measures were in progress to fully ensure this, following transition of some people’s care from a care home setting to the provider’s supported living service. This helped to fully ensure the principles and values of Registering the Right Support for people’s care but was not yet fully embedded in practice.

The service continued to be safe. The provider’s arrangements for people’s care helped to protect them from the risk of harm or abuse. Staff were safely recruited and deployed to provide people’s care. Risks associated with people’s health condition and any care equipment were effectively accounted for. People were supported to take their medicines safely when needed. The provider acted when things went wrong at the service following a specific incident resulting in a person’s serious injury, to help prevent any reoccurrence. The incident is subject to a criminal investigation by the local police authority. As a result, this inspection did not examine the circumstances of the incident.

The service was now effective. Staff mostly supported people in the least restrictive way possible and in their best interests. Management remedial action was taken when this had not occurred without a delay, to prevent any reoccurrence. The provider’s policies and systems in the service supported least restrictive care principles. People’s care needs were effectively accounted for through regular consultation with them. Staff supported people to maintain or improve their health and nutrition when needed. This included to ensure consistent, timely support if they needed to move between services for any care and treatment.

People continued to receive care from kind, caring staff. The provider promoted an inclusive culture of shared care values to help ensure people’s equality and rights in their care. Staff knew people well, what was important to them for their care. People were informed, involved and supported to understand, agree and make ongoing decisions about their care.

The service was now well led. Revised governance, operational management and a comprehensive engagement strategy, helped to inform and ensure the quality and safety of people’s care and targeted service improvement when needed. Effective staff support, communication and record keeping systems also helped to ensure this. Staff understood their role and responsibilities for people’s care. Relevant partnership working with external educational, health and social care agencies and authorities, helped to inform and optimise people’s care experience. The provider met with the legal requirements of their registration with us.

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 (report published April 2018)

Why we inspected

This was a planned inspection based on the previous rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner