Background to this inspection
Updated
17 May 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector and an expert by experience who undertook telephone interviews with people who used the service and 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.
The service had a registered manager in post. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. 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.
Notice of inspection:
We gave the service two working days’ notice of the inspection site visits to discuss the inspection plan with the registered manager and make arrangements to visit some supported living settings. This was needed so that people who used the service were consulted and agreements sought from them for a home visit from an inspector, or to be contacted by telephone.
What we did:
Prior to our visit, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service. We also reviewed information we held about the service. This included notifications we had received. A notification is information about important events that the provider is required to send us by law.
The inspection site visit activity started on 9 April 2019 and ended on 10 April 2019. At the office location, we reviewed five staff personnel records and training files, incident and accidents records, audits and a sample of policies and procedures. We also visited five of the schemes, spoke with people living in their homes and met with the scheme managers and staff, reviewed support plans and checked medicines management. We spoke by telephone with two people who used the service, five relatives of other people and three members of staff. We emailed four social care professionals who were involved in placing people with the service but did not receive a reply.
Updated
17 May 2019
About the service:
¿ Supporting you in London and Thames Valley provides a supported living service to people living in their own flats or shared accommodation within ten ‘supported living’ schemes. The aim is for people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements.
¿ Not everyone using the service received a regulated activity; 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. At the time of our inspection, 33 people were receiving personal care.
¿ Each scheme had a manager in post, and a registered manager oversaw the ten schemes.
¿ 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 mental health needs using the service can live as ordinary a life as any citizen.
People’s experience of using this service:
¿ The provider had effective arrangements to protect people against the risks associated with the management of medicines.
¿ There were systems and processes to help protect people from the risk of harm. There were enough staff on duty to meet people's needs and there were contingency plans in the event of staff absence. Employment checks were in place to obtain information about new staff before they were allowed to support people.
¿ Care plans and risk assessments were reviewed and updated whenever people's needs changed. People and relatives told us they were involved in the planning and reviewing of their care and support and felt valued.
¿ The risks to people's safety and wellbeing were assessed and regularly reviewed. People were supported to manage their own safety and remain as independent as they could be. The provider had processes in place for the recording and investigation of incidents and accidents and lessons were learnt when things went wrong.
¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
¿ Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Act. The provider had liaised with the local authority when people required Court of Protection decisions with regard to being deprived of their liberty in the receipt of care and treatment. At the time of our inspection, nobody was being deprived of their liberty unlawfully.
¿ People were protected by the provider’s arrangements in relation to the prevention and control of infection. The provider had a procedure regarding infection control and the staff had specific training in this area.
¿ People’s health and nutritional needs were recorded and met. Where possible, people using the service were supported to shop for ingredients and cooked their own food. Staff supported people to attend medical appointments where support was required.
¿ People were supported by staff who were sufficiently trained, supervised and appraised.
¿ A range of activities were arranged that met people’s individual interests and people were consulted about what they wanted to do.
¿ Staff were caring and treated people with dignity, compassion and respect. Support plans were clear and comprehensive and included people's individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided.
¿ People told us, and we saw staff supported them in a way that took into account their diversity, values and human rights. People confirmed they were supported and encouraged to be involved in the running of the service and felt valued.
¿ Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management.
¿ People, relatives and staff told us that the registered manager was supportive, approachable and hands on. Staff were supported to raise concerns and make suggestions about where improvements could be made.
¿ The provider had some systems in place to monitor the quality of the service and where issues were identified, these were addressed promptly.
Rating at last inspection:
¿ At the first inspection of the service on 17 and 20 April 2018 the service was rated requires improvement in the key questions of ‘safe’, ‘responsive’ and ‘well led’ and overall. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, responsive and well led to at least good. During this inspection we found the service had made the required improvements and met all the Regulations.
Why we inspected:
¿ This was a planned inspection based on the previous rating.
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 any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk