The inspection took place on 10 and 11 November 2016. North Supported Housing and Domiciliary is a service that provides personal care and support to people who either maintain a tenancy in supported living accommodation or who live in their own homes.This was an announced inspection. The provider was given up to 48 hours’ notice because the service provides care and support in people’s homes and we needed to be sure someone would be available at the time of our inspection.
At the time of the inspection the service provided care, including 24 hour support, to eight people living in two supported living accommodations, plus 41 people living in their own homes.
There were two registered managers in post to cover the two aspects of the service; supported living and domiciliary. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
Risks to people's safety were assessed and reviewed. There was a wide range of risk assessments relating to people’s safety, which included more diverse risks associated with accessing the community. For people receiving care at home, risk assessments could be broadened to include screening tools for people at risk of malnutrition and assessment of skin integrity.
Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.
People had confidence in the staff that supported them. There were enough staff to provide care and to offer flexibility in the service. Staff received training to enable them to deliver effective care. They were supported in their roles by a system of supervision and appraisal.
There were formal recruitment procedures in place, which included Disclosure and Barring Service (DBS) checks, prior to people starting work in the service. Some staff files did not contain reference checks on previous employment history, but this was addressed promptly by the management team.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People who used the service, their relatives, and people closely involved in their care were involved and consulted. People were always asked for their consent before staff assisted them with any tasks. Staff respected people's privacy and people were treated with respect and dignity.
Systems were in place to ensure people's medicines were managed in a safe way, and people received their medicines in a timely manner.
Staff supported people to prepare meals and to eat and drink if required. Where people could benefit from additional support, referrals were made to other healthcare professionals.
There was an open door policy and a positive culture in the service. Staff felt comfortable to approach the registered managers for advice and guidance and felt able to raise concerns or issues as necessary. They told us they were listened to and action was taken promptly when required.
The provider had an effective quality monitoring system to ensure standards of service were maintained and improved. People were asked for feedback on the quality of the service they received and they were provided with information on how to make a complaint.