Background to this inspection
Updated
27 October 2021
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Our inspection was completed by two inspectors.
Service and service type
This service provides care and support to people living in three 'supported living' settings next door to one another, so that they can live 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.
The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. There was a new manager working at the service who supported us on the inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
Due to the complex needs of people using the service we were unable to speak with them or observe care. We did not want to cause anxiety to people with our presence. We spoke with four members of staff including the manager and care staff.
We reviewed a range of records. This included two people's care records and their medication records. We reviewed a variety of records relating to the management of the service, agency staff profiles and policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one relative of a person using the service.
Updated
27 October 2021
About the service
Shine Supported Living - South East is a supported living service registered to provide personal care. The service provided care and support to seven people with a learning disability or other complex needs living in supported living' settings, so that they can live in their own home as independently as possible. 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. Two people were in receipt of personal care when we visited.
People’s experience of using this service and what we found
People were not being protected against abuse. There were instances of harm taking place at the service where appropriate action had not been taken by the provider to mitigate the risk of harm occurring again. The local authority were not always being informed when safeguarding incidents occurred.
The behaviour that challenged people was not being managed in a safe way. Behaviour charts were not being completed for people where required to do so. Staff had not always received appropriate training to ensure they could meet people’s needs. There were not always sufficient staff to safely support people.
The leadership at the service was not robust and there was not sufficient auditing by the provider to review the quality of care provided. Notifications were not always being sent to the CQC when it was appropriate to do so.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People were not always supported with their independence. Staff did not always have an understanding of the support and care people needed to enable them to have a fulfilled life.
Right support:
• Model of care and setting did not maximise people's choice, control and Independence
Right care:
• Care was not person-centred and did not promotes people's dignity, privacy and human rights
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff did not ensure people using services lead confident, inclusive and empowered lives
Following this inspection, we worked closely with local authorities to ensure people were safeguarded from ongoing harm. Two people were supported to move out of the service.
Rating at last inspection (and update)
The last rating for this service was Requires Improvement (published 10 January 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found sufficient improvements had not been made and the provider remained in breach of regulations.
The service is rated as inadequate in the key questions Safe and Well Led.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We received concerns in relation to people being safeguarding from the risk of abuse. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.
We reviewed the information we held about the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the Safe, and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shine Supported Living - South East on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to people not being protected from the risk of neglect and abuse, risks related to the care being provided to people, the lack of suitably qualified staff and the lack of robust provider and management oversight at this inspection.
We took action against the provider and cancelled their registration at Shine Supported Living. Everyone who received a regulated activity has moved out of the service, and we have de-registered Shine Supported Living with the Care Quality Commission.