Forge House Care

Updated 25 August 2022

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

Two inspectors carried out this inspection.

Service and service type

This service provides care and support to people living in 32 supported living settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements in supported living settings. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support

The service had three managers 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 short notice as we needed to be sure the provider or a registered manager could be available to support the inspection.

Inspection activity started on 11 May 2022 when we visited the office location and ended on 13 May 2022 when we visited people in their homes.

What we did before inspection

We asked for feedback from commissioners of people’s care and local authority staff involved in people’s care. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke with ten members of staff including two registered managers, the training manager, office staff and six support staff including senior support workers.

We reviewed a range of records. This included five people’s care records and five medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 25 August 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Forge House Care is a supported living service providing personal care to 32 people who had a learning disability and/or autism at the time of the inspection.

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

Right Support

People were not always supported to make decisions following best practice in decision-making. People were not supported appropriately to understand their rights regarding their tenancy and support.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported to do as much as they could themselves, enhancing their independence, while at the same time being supported to stay safe.

The service worked with people to plan for when they experienced periods of distress so that if they had to have restrictions to keep them safe it was only when there was no other alternative.

Staff enabled people to access specialist health and social care support in the community to make sure they could continue to lead a healthy and fulfilling life.

Right Care

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s individual needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood how they communicated.

People’s care and support plans reflected their range of needs and this promoted their safety, wellbeing and enjoyment of life.

Right culture

People were not given the opportunity to exercise their right to choose who supports them in their own home. A supported living service is required to register with CQC to provide ‘personal care’, not ‘accommodation with personal care’. For this to apply there should be separate legal agreements for the accommodation and the personal care. People did not have separate agreements for their care and their housing, both were part of a single package of care, which restricted their right to choose.

People received safe care and support because trained and well supported staff and specialists could meet their needs and wishes.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this inspection due to concerns raised about whether people were receiving safe support. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. At this inspection, we found people were receiving safe support.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed to requires improvement, we have found evidence that the provider needs to make some improvement. Please see the safe and well-led sections of this report. This is based on the findings at this inspection.

The last rating for this service was Good (published 1 November 2017)

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.