Background to this inspection
Updated
19 May 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 service provides care and support to people living in 19 ‘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.
We gave the service 48 hours’ notice of the inspection visit to ensure we had access to the office base and because we needed to be sure that they would be in.
The inspection team consisted of one adult social care inspector.
The inspection site visit was on 19 April 2018. We also visited two supported houses, telephone interviews with eight people who lived in the houses and three relatives.
Prior to this inspection, as part of our planning, we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are required to be submitted by the provider to the Care Quality Commission to advise of important events.
We received information from the local authority to gain their feedback about the care people received. This helped us to gain a balanced overview of what people experienced when accessing the 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.
During the inspection, we spoke with eleven people who lived in supported houses, four relatives and ten support workers. We also spoke with the two registered managers of the service and two team managers. In addition we spoke with two social workers who had involvement and supported people at Lancashire Domiciliary Care. We looked at the care records of four people who lived in supported houses in the office and where they lived. Also we looked at medication records, training and recruitment records of staff.
In addition we looked at records relating to the management of the service. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead the agency in ongoing improvements. We also looked at staffing levels focusing on how staff provided care within the supported homes.
Updated
19 May 2018
The service provides domiciliary care 24 hours a day in supported houses where people live. Support is provided for people who live with a learning disability. The location of the homes are based around the Lancaster and Morecambe area. The office is based at the Lancashire County Council building in Lancaster.
At the time of our inspection there were 19 supported living homes and 53 people who received support from the service.
At the last inspection in March 2016 the service was rated Good. At this inspection we found the service remained Good. This inspection report is written in a shorter format because our overall rating of the service had not changed since our last inspection.
There was a registered manager in place. 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.
The management team had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.
Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care and within supported houses. These had been kept under review and were relevant to the care provided.
Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.
Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. This was confirmed by talking with staff and the management team. Medication records checked were accurate and up to date in the supported houses we visited.
People in supported houses were supported to have access to healthcare professionals and their healthcare needs had been met. Care plans looked at reflected this.
Care plans were organised and had identified the care and support people required. We found they were personalised and informative about care people received. They had been kept under review and updated when necessary. They reflected any risks and people’s changing needs.
Staff had received food and hygiene training to ensure they were confident when preparing meals. People who lived at the houses were complimentary about the food provided and their involvement in the preparation of meals. One person said, “I love the meals we all choose what we want.” Also, “I help out with shopping I like to do that.”
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People’s care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.
People and relatives we spoke with told us staff them treated them with respect and dignity.
People were supported to follow their chosen interests and hobbies. For example some people attended college, others participated in some voluntary work. Others attended events in the local community.
People who used the service and their relatives knew how to raise a complaint and who to speak with. The management team had kept a record of complaints received and these had been responded to in a timely manner.
The management team used a variety of methods to assess and monitor the quality of the service they provided. For example they included regular staff meetings, management team meetings and each property had resident/house meetings. Surveys were also sent to relatives and staff to complete every year.