Archived: Derby and Derbyshire Supported Living

Derby and Derbyshire 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 14 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 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 was appropriate and inclusive for them. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service and what we found

People were supported by staff who had the knowledge and skills to ensure they were safe from harm. Risk assessments had been completed to consider what support was needed in these areas to reduce any risk identified. Staff were recruited in line with best practice and the number of staff were reflective of the package each individual needed. Medicines were managed safely, and staff ensured clear infection control measures were in place. The registered manager had reflected on incidents and lessons had been learned.

People’s care was provided by staff, which people and relatives told us were kind and compassionate. People’s needs were respected, and individual care was provided in a dignified way. Care plans were reflective of individual needs, and any support required with communication, or with access to any social, cultural or religious practices was clearly identified.

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 had received training relevant to their role. Where people required support with their nutritional needs this was documented, and staff accessed additional advice and support when required. Good health care was promoted, and staff worked in partnership with a number of local health and social care professionals.

The registered manager ensured that any complaints, including verbal complaints, had been responded to and people who used the service, their relatives and staff were encouraged to give feedback about the service. There was a range of improvements ongoing which were being continually updated by people’s feedback, from the provider outcomes and in line with the changes in market share.

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 the thematic review, we carried out a survey with the registered manager 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. No restrictive intervention practices were used.

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 Good (published 18/02/2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

There is a registered manager at the service. 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.

MHT Midlands is a supported living service which provides people with personal care and supports people, with a range of health and social care needs, to live in the community. At the time of our inspection, 16 people were receiving care and support from the provider.

The day-to-day management of the service and staff was carried out by the registered manager. The registered manager and staff had a sound understanding about the people who used the service. The service was focused on the needs of individuals and there was a commitment by the registered manager and the staff, to ensure people received the care and support they wanted and needed.

The service was focused on each person and accounted for personal likes, dislikes, needs and aspirations. Staff encouraged people to make their own day-to-day decisions and respected those decisions whilst balancing people’s safety.

Staff were aware of the need to keep people safe and to protect them from the risk of potential harm or abuse. Staff and the registered manager understood procedures in relation to safeguarding and ensured any allegation of abuse was recorded and reported in the appropriate manner.

People were cared for by staff who had demonstrated their suitability for their respective role. Recruitment procedures were safe and included Disclosure and Barring service (DBS) checks.

People’s medicines were managed safely and in accordance with current regulations and guidance. Staff received training in medicines administration and competency assessments were carried out.

Staff participated in training and supervision; they understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA). Capacity assessments and best interest decisions were available in people’s care plans.

Staff supported each person in a manner which promoted people’s independence. People were encouraged and supported to take part in activities of their choice. People’s right to privacy and dignity was respected by staff. Staff were kind, caring and compassionate; relationships between staff and people were positive.

Staff received training to ensure they were providing appropriate and effective care and to support people and their individual needs. People were involved in the assessment and planning of their care and care plans; we saw information was provided to people in different formats, to ensure they were included.

Staff felt they were supported by the registered manager; staff thought the team worked well together. The registered manager had effective auditing systems in place to assess and monitor the quality of the service. People and their relatives were asked for their opinions and views about the service they received.