Background to this inspection
Updated
10 November 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 11 and 12 October 2018 and was announced. The provider was given 48 hours’ notice because the location provides a service for younger adults who are often out during the day; we needed to be sure someone would be in to assist us.
The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually, to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law.
We contacted community professionals, for example, the local authority commissioners of the service, to seek their views about people’s care. We also contacted four people’s relatives after the inspection, to ask them about standards of care.
We spoke with the registered manager and two staff members. We had informal discussions with four people who used the service. We checked some of the required records. These included three people’s care plans, five people’s medicines records, three staff recruitment files and staff training and development files. We also observed a staff meeting.
Updated
10 November 2018
This inspection took place on 11 and 12 October 2018. It was an announced visit to the service.
We previously inspected the service in August 2017. The service was not meeting all of the requirements of the regulations at that time and was rated ‘requires improvement’. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘safe’ and ‘well-led’ to at least ‘good.'
This service provides care and support to people living in two 'supported living' settings, so that they can live in their own home 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.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service can provide support for up to 12 people. Eleven people were using the service at the time of our inspection. In one setting, people lived in a shared house and had their own bedroom with en-suite facilities. In the other setting, people lived in self-contained studio flats.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.
We found improvements had been made in the areas where the service was previously not meeting the regulations. These were in relation to medicines practice and notification of significant events.
People told us they liked living at the service. Relatives were complimentary of care. For example,
"The staff cope well with the diversity of all the different adults. Everyone seems to be happy. On the whole they do a good job caring" and "I've seen staff be patient, kind and compassionate." Some relatives had concerns people had put on weight and also about personal hygiene. The registered manager told us encouragement was given to follow healthier diets, to exercise and to attend to personal care.
People were supported to be independent at the service. They had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were safeguarded from the risk of abuse or harm. Written risk assessments supported people to keep safe.
There were sufficient staff to meet people’s needs. They were recruited using robust procedures to make sure people were supported by staff with the right skills and attributes. Staff received appropriate support through a structured induction, regular supervision and appraisal of their performance. However, this was not the case for the registered manager. We have made a recommendation for them to receive regular supervision. There was an on-going training programme to provide and update staff on safe ways of working
Care plans had been written, to document people’s needs and their preferences for how they wished to be supported. These had been kept up to date to reflect changes in people’s needs. People were supported to take part in a wide range of social activities. Staff supported people to attend healthcare appointments to keep healthy and well.
There had not been any complaints about the service. People knew how to raise any concerns and were relaxed when speaking with staff and the registered manager.
The service was managed well. The quality of care was assessed through surveys and audits. Records were maintained to a good standard and staff had access to policies and procedures to guide their practice.