Background to this inspection
Updated
12 December 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 was planned to check 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 comprehensive inspection took place on 14 November 2018 and was unannounced.
The inspection team consisted of one inspector. Prior to this inspection, we reviewed information we held about the service such as notifications. These are events that happen in the service the provider is required to tell us about. We also considered the last inspection report and information that had been sent to us by other agencies. We also contacted commissioners who had a contract with the service.
During the inspection, we spoke with four people who used the service and one relative of a person who used the service for their views about the service they received. We spoke with the registered manager and two care staff.
We looked at the care records of two people who used the service. The management of medicines, staff training records, staff files, as well as a range of records relating to the running of the service. This included audits and checks, the management of fire risks, policies and procedures, complaints and meeting records.
Updated
12 December 2018
We inspected Community Living and Support Services (CLaSS) on 14 November 2018. The inspection was unannounced. CLaSS is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates five people who have a learning disability or Autism spectrum disorder.
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.
On the day of our inspection five people were using the service.
At our last inspection on 3 November 2015 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall but there had been a deterioration in safe which was rated as ‘requires improvement’. There was no evidence or information from our inspection and ongoing monitoring which demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service was rated as ‘requires improvement’ for ‘safe’ at this inspection. The processes in place for the administration of medicines were not always in line with good practice. Medicine administration records were not completed in line with the prescribers’ instructions. Protocols for medicines which were given as and when required did not offer clear advice on when these should be given. Risks associated with people’s needs had been assessed and measures were in place to reduce risks. There were sufficient staff to meet people’s needs and safe recruitment procedures for staff were in place. Accidents and incidents were monitored to identify any trends and measures were put in place to reduce the likelihood of these happening again.
People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have 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. The principles of the Mental Capacity Act (MCA) were followed.
People continued to receive care from staff who were kind, compassionate and treated them with dignity. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to support people when they were distressed and made sure emotional support was provided. People’s independence was promoted.
People continued to receive a responsive service. People’s needs were assessed and their support was planned with them and or their relative where required. Staff knew and understood people’s needs well. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaints procedure available if this was needed.
People continued to receive a well-led service. The monitoring of service provision was effective because most shortfalls had been identified and resolved. There was an open and transparent and person-centred culture with adequate leadership. People were asked to share their feedback about the service.
Further information is in the detailed findings below.