10 May 2022
During a routine inspection
About the service
Transparent Care Limited is a supported living service providing personal care in shared houses and bungalows across a wide geographical area. At the time of the inspection the service supported 71 people with a learning disability, autism or living with mental ill health.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Right Support
The service worked with people’s funding authorities to identify people who needed a Court of Protection derivation of liberty y authorisation to keep them safe. There was no system to track the progress of applications to ensure outcomes were known and shared with staff teams. We have made a recommendation about this.
People’s care plans contained detailed information about many aspects of their physical and emotional needs, however, protected characteristics such as gender identify and sexuality were not captured. We have made a recommendation about this.
The service supported people to have the maximum possible choice and independence and they had control over their own lives.
The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.
Right Care
The service did not consistently identify or report safeguarding concerns. The registered manager had acted to improve this through increased monitoring systems. Other concerns were reported appropriately and the service worked well with other agencies to protect people from poor care and abuse in these cases. We have made a recommendation about safeguarding.
We received feedback that some agency staff were not appropriately skilled or demonstrate the right values to meet people’s needs and keep them safe. The service was aware of these concerns and we saw evidence they were acting to improve this. We have made a recommendation about agency staff.
Other staff demonstrated commitment and compassion towards people and received mandatory and specific training to benefit people. The service had taken action to ensure refresher training was planned where this had lapsed in some cases during the COVID-19 pandemic.
The service did not consistently ensure assessments documented all identified risks to people. Some health and safety checks such as water safety were not robust. Safe medicines systems were not always implemented by staff. We have made a recommendation about this. The service took action to address these short falls. In practice, staff were knowledgeable about risks to people and took action to mitigate risk with people.
We found most people could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. Some people’s activity opportunities were discontinued due to COVID-19 restrictions; the service was in the process of supporting people to source and access other opportunities in the community.
People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.
Right Culture
The ethos, values, attitudes and behaviours of leaders and staff ensure that people using the service lead inclusive and empowered lives. We received mixed feedback about the leadership team. Some felt managers were supportive and valued their input, others felt managers were not doing enough to address their concerns. We raised this with the registered manager who shared their action plan to address concerns.
The service acknowledged that quality assurance monitoring systems had lapsed during the COVID-19 pandemic whilst the service focused on managing risk. There was a clear commitment from the registered manager to drive improvement and we saw evidence of recent progress. We have made a recommendation about quality monitoring to ensure improvements are sustained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (29 December 2017).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. The inspection was prompted in part due to concerns received about staffing, governance and the management of risk to people. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
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.