Background to this inspection
Updated
23 March 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 inspection took place on 20 February 2018 and was announced. The provider was given 48 hours’ notice because the location was a service for people who are often out during the day; we needed to be sure that someone would be in. The inspection team consisted of one adult social care inspector, a CQC pharmacy inspector and an expert by experience who made telephone calls to people and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We reviewed other information we held about the service, including any statutory notifications we had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. Before the inspection, we also contacted the local authority commissioners for the service and the local authority safeguarding team to gain their views of the service provided.
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.
We looked at two care records for people who used the service. We examined three sets of staff files which covered recruitment, supervision and training records and various records about how the service was managed. We spoke to seven relatives of people who used the service over the telephone, the registered manager, service director, project manager and four staff members. People who used the service were unable to communicate verbally. Due to staff working in a large geographical area we provided questionnaires for them to complete and we received 21 back. We visited one of the services to check their medicine records.
Updated
23 March 2018
This inspection took place on 20 February 2018 and was announced.
This service provides care and support to fifteen people living in four ‘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.
The service had a registered manager in post. 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. Each supported living setting had a project manager in place.
At the last inspection in December 2015, the service was rated Good. At this inspection we found the service remained Good.
Risk assessments were in place with full information on steps that should be taken to reduce the risks.
Staff had received training in safeguarding adults and the registered manager understood their responsibilities to identify and report any concerns. Safe recruitment processes were followed to ensure only suitable people were employed. The services did have a shortage of staff and the provider was in the process of trying to employ more staff. Agency staff were being used in the meantime. Staff raised concerns about the shortage of staff and having to work long hours to cover this. This was looked into by the service director.
Medicines were managed safely and people received their medicines as prescribed. We have made a recommendation about the management of when required medicines.
People accessed health and social care professionals. People benefited from strong, caring relationships with staff that treated them with dignity and respect.
People received effective care from staff that had the skills and knowledge to support them. We have made a recommendation about training.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service support this practice. Consent to care and treatment was clearly documented and appropriate authorisations were in place when people lacked capacity to make decisions.
Activities were developed around people’s interests. People were supported to maintain relationships and access the local community.
Effective management systems were in place to monitor the quality of care provided and to promote people's safety and welfare. Staff did not feel supported by the management team and stated morale was low.