Background to this inspection
Updated
10 January 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 8 and 9 November 2017, and was undertaken by two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their involvement was phoning relatives of people using the service to ask them their views of the service.
We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often at one of the supported living schemes as part of their managerial roles. We needed to be sure that they would be available for the inspection visit.
The inspection was informed by feedback from questionnaires completed by three people using the service, one relative, and five staff. The feedback was mainly positive, but also led the inspection team to explore a few areas of feedback.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least annually to give some key information about the service, what the service does well and improvements they plan to make.
Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law. We also contacted the local authority and other community professionals involved in the service for their views, however, we received no replies.
Inspection site visit activity started on 8 November 2017 and ended on 9 November 2017. It included visits to three supported living schemes, to meet people living at those schemes, staff working with them, and to check records kept at the schemes. We also carried out observations of people's interactions with staff and how they were supported, as some people were unable to communicate with us due to the complexity of their conditions.
We also visited the office location on 9 November 2017 to meet the manager and office staff; and to review records relating to the management of the service.
There were 15 people using the service at the time of our inspection visit. During the inspection, we spoke with four people using the service, three relatives, one visitor, four support staff, two agency staff, three scheme managers, and the registered manager.
We reviewed the care records for six people living at the service to see if they were up-to-date and reflective of the care which people received. We also looked at personnel records for three members of staff, including details of their recruitment, training and supervision. We reviewed further records relating to the management of the service, including staffing rotas and quality assurance processes, to see how the service was run. We then requested further specific information about the management of the service from the registered manager following our visits.
Updated
10 January 2018
This was the first inspection of this service. It provides care and support to adults with learning disabilities or autism, physical disabilities, sensory impairments and/or dementia. The care and support is provided in six ‘supported living’ settings, so that people 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.
CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
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.
The service had a registered manager, which 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.
There was good overall feedback about the service, from people using it and their relatives. We found people were treated with kindness and compassion, and that they were given emotional support when needed. The service ensured people's privacy and dignity was respected and promoted.
People’s needs were identified and responded to well. The service was very effective at working in co-operation with other organisations to deliver good care and support. This included where people’s needs had changed, and where people needed ongoing healthcare support. The service helped people to live healthier lives, and to have their nutritional and medicines needs met.
The service enabled people to receive personalised care and recognised their potential. For example, people were supported to follow their interests, and to develop and maintain relationships that mattered to them. People’s friends and relatives were able to visit and keep in contact without being unnecessarily restricted.
As far as possible, the service supported people to express their views and be actively involved in making decisions about their care and support. There was an open, positive and transparent culture at the service. People’s concerns and complaints were responded to and used to improve the quality of care.
The service ensured there were sufficient numbers of suitable staff to support people to stay safe and meet their needs. This included through safe recruitment practices. Staff had the skills, knowledge and experience to deliver effective care and support, and received support for their roles.
Risks to people using the service were assessed and actioned, to balance their safety with their freedom. The service promoted people’s independence. The service’s systems, processes and practices safeguarded people from abuse, and there were sufficient systems for the prevention and control of infection.
The service was working towards ensuring it supported people to be protected by the Mental Capacity Act 2005 in the event they lacked capacity to make some decisions.
The provider’s governance framework ensured quality performance, risks and regulatory requirements were understood and managed. There was good use of online monitoring tools in support of this. The service learnt and made improvements when things went wrong.
The provider had a clear vision and credible strategy to deliver high-quality care and support. The strategy was well-embedded at this service. Systems at the service supported continuous learning and improvement.