This inspection took place on 1 and 4 December 2017 and was announced to ensure that the registered manager or appropriate person would be available to assist with the inspection. This was the first inspection since the service became registered. This service provides care and support to 13 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.
Although there was a registered manager this person was no longer managing this service and had submitted an application to cancel their registration. 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. A new manager had been appointed and planned to submit an application to CQC to become the registered manager. Throughout the report we refer to this person as the manager.
Staff were extremely person centred in their approach which was enabled and supported by the provider. They provided compassionate, caring support which encouraged people’s communication and development of their independence. Staff worked exceptionally well with people and others to develop people’s skills and ensure they were receiving a service that they needed. People were very comfortable, relaxed and confident in the company of staff. Care plans were person centred and staff responded to people’s changing needs. Activities were based on individual preferences. The provider had found different means to engage and involve people, including employing them as experts to audit services.
Systems to ensure staff recruited were of good character were operated effectively and staffing levels were based on individual’s needs. The provider delivered training and ensured support and supervision was in place to enable staff to undertake their roles effectively.
Staff had a clear understanding of the needs of people and worked well as a team and with other professionals. They knew about any risks to people as a result of their physical and emotional needs as well as what action to take to minimise the risks. Medicines were safely managed. People were protected against abuse. Policies and procedures were available to everyone who used the service. The manager and staff recognised their responsibilities and duty of care to raise safeguarding concerns when they suspected an incident or event that may constitute abuse.
Staff understood the need for consent and demonstrated the principles of the Mental Capacity Act 2005 were understood and applied appropriately. They ensured people were involved in all aspects of the care and support. Where necessary staff involved others such as families to aid the development of clear support plans. Other health professionals were accessed to ensure people’s health care needs were met. People were supported in environments which suited their needs.
Staff were confident that the manager was knowledgeable and would take appropriate action if any concerns were raised. They felt supported and that the manager was easy to approach. The manager operated an open door policy and in order to provide clear leadership spent time visiting services.
Systems were in place which continually monitored the service to ensure this was safe and of good quality.