Background to this inspection
Updated
30 March 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
One inspector conducted the inspection over two days.
Service and service type:
This service provides 24-hour care and support to people living in ‘supported living’ setting, 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.
The manager of the service was in the process of registering with the Care Quality Commission. The 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 service 48 hours’ notice of the inspection visit. We needed to be sure that managers would be available to facilitate this inspection.
What we did:
We used information the provider sent us in the Provider Information Return (PIR) to support out inspection. This is key information we require providers to send us about the service, what the service does well and improvements they plan to make.
We looked at information we held about the service including notifications they had made to us about important events. A notification is information about certain changes, events and incidents affecting the service or the people who use it that providers are required to tell us about. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.
We visited the service’s office and the home of the person using the service. We spoke with a relative to ask about their experience of the care provided. We also spoke with four members of staff, the manager and the area manager.
We viewed the person’s care records, policies and procedures, records relating to the management of the service, various staff training and competency records and the recruitment records of four support workers.
After the inspection we spoke with an adult social care professional involved with the service.
Updated
30 March 2019
About the service:
¿ NAS Community Services (Harrow) provides care and support to people with learning disabilities and/or autism living in a ‘supported living’ setting, 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.
¿ The service supported people to live in a two-bedroom semi-detached house that was situated in an ordinary residential area and blended in with its surroundings. People had their own bedrooms and one of these had an en-suite bathroom. People shared the rest of the house and garden. There was an additional sleeping-in room for staff staying overnight. A team of care staff supported people during the day and there were two staff on shift during the night. The service was supporting one person when we inspected. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
People’s experience of using this service:
¿ Some aspects of the service were not consistently safe as the provider did not always ensure the safe and proper management of medicines. The provider could not always ensure that people received their ‘when required’ prescribed medicines as intended. The provider had not sufficiently assessed staff to ensure that they were competent to give the medicines support being asked of them. The provider did not always accurately record the amount of medicines stored at the service.
¿ Some aspects of the service were not consistently responsive as people’s care plans did not fully reflect their physical, mental, emotional and social needs. We have made a recommendation about developing person-centred care.
¿ Some aspects of the service were not consistently well-led as the quality checking systems had not identified and addressed the issues we found regarding the safe management of medicines and the person’s support plan.
¿ One relative told us, “I'm a fan of the National Autistic Service. They know what autism is, it’s not just any staff coming in. I can’t think of [the person] being with anyone else.”
¿ Staff were aware of the person’s individual needs, preferences and routines. They used their knowledge to deliver person centred care. Relatives felt that staff cared and treated them with respect and dignity. Staff were responsive to the person’s needs.
¿ The service provided people with activities that were meaningful to them and they could choose how they spent their time.
¿ Staff received induction, training, supervision and support to perform their roles effectively.
¿ Staff supported people to manage behaviours that may challenge others in line with best practice.
¿ The outcomes for people using the service mostly reflected the principles and values of Registering the Right Support in the following ways. People's care and support was planned and coordinated but the care plans were not as person centred as they could have been. People had a choice about who they lived with. People were supported to maintain their home the way they wanted it. People’s family and support staff were involved in supporting the person to live in the community. Support focused on promoting people’s choice and control in how their needs were met. Support and interventions were provided in the least restrictive ways and staff promoted a relaxed home environment. This approach promoted people with learning disabilities and/or autism to live an ‘ordinary’ life as any other citizen.
¿ We identified breaches of regulations in relation to safe care and treatment and good governance. You can see what action we have asked the provider to take within our table of actions.
Rating at last inspection:
¿ We rated the service “good” at our last inspection. We published our last report on 8 July 2016.
Why we inspected:
¿ This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
¿ We will continue to monitor intelligence we receive about the service until we return to visit as
per our re-inspection programme. We may inspect sooner if we receive any concerning information regarding the safety and quality of the care being provided.