Background to this inspection
Updated
12 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was an announced inspection which took place over two days on 10 and 17 January 2018. The inspection was carried out by an adult social care inspector.
Prior to the inspection we accessed and reviewed the Provider Information Return (PIR) as we had requested this of the provider before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service.
During the inspection we could see and interact with five of the people who received care from Hope Street when we visited two of the supported living houses. On the second day of the inspection we visited the central offices for the service to review the quality systems in place and speak with senior managers. We also contacted and received feedback from five relatives of people being supported by Hope Street.
We spoke with two health and social care professionals who gave us feedback about the service which was wholly positive.
We spoke with eight staff including care/support staff, a ‘cluster’ manager, the quality manager, the registered manager and the nominated individual [acting for the provider] for the service.
We looked at the care records for three of the people being supported, including medication records, three staff recruitment files and other records relevant to the quality monitoring of the service such as safety audits and quality audits.
Updated
12 January 2019
Hope Street supports people who have learning disabilities or mental health conditions living in supported living houses around Merseyside including Southport. The service is registered to deliver personal care and the offices are based in Hope Street, Liverpool. The service currently supports 150 plus people.
In ‘supported living’ settings, people are tenants and can live in their own home and be supported to be as independent 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.
For people who have a learning disability, 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 for people with learning disabilities. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
This was an announced inspection which took place over two days on 10 and 17 December 2018. The inspection was carried out by an adult social care inspector. Hope Street was newly registered with the Care Quality Commission [CQC] in November 2017 [Although existed as a support service prior to this]; as such this was a first inspection and quality rating.
We found the service to be providing good care for the people they supported. The overall culture of the service was very positive and the quality assurance process ensured consistent standards with a focus on ongoing service development.
We rated the service as Good.
The service had a registered manager in post. 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.
The observations we made and feedback we received evidenced people were getting good support. External professionals involved in peoples care also gave positive feedback which gave further evidence of a good service.
We found medicines were administered safely. Medication administration records [MARs] were completed in line with the services policies and good practice guidance. There was a positive focus on getting people to safely manage their own medication.
There were arrangements in place for checking the care environment to help ensure this was safe. These arrangements included regular checks and audits by house managers and ‘cluster’ managers which were supported by health and safety audits by other senior managers.
People using the service, relatives, professionals and staff told us they felt the culture of the organisation was fair and open and supported good care and support for people using the service.
People we spoke with said they felt safe with the staff from the agency and the support they received. We were told that if any issues arose they were addressed by the managers. The staff we spoke with clearly described how they recognised abuse and the action they would take to ensure actual or potential harm was reported. All the staff we spoke with were clear about the need to report through any concerns they had.
We reviewed past safeguarding investigations and the agency had followed procedures and liaised well with safeguarding authorities. Agreed protocols had been followed in terms of investigating and ensuring any lessons had been learnt and effective action had been taken. This rigour helped ensure people were kept safe and their rights upheld.
We saw that any risks to care provision had been assessed and there were fully developed plans in place to help ensure they were kept safe. Staff were arranged to support this depending on each person’s needs. There were sufficient staff available to support people.
We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. Appropriate applications, references and security [police] checks had been carried out.
We saw that people’s consent to care was recorded. The service worked in accordance with the Mental Capacity Act 2005.
Feedback from people and their relatives told us that staff seemed well trained and competent. Communication between relatives, people being supported, staff and senior management was effective.
Staff were supported by on-going training, supervision, appraisal and staff meetings. Formal qualifications in care were offered to staff as part of their development.
Local health care professionals, such as the person’s GP and the Community Mental Health Team [CMHT] were involved with people and staff from Hope Street liaised when needed to support people. This helped ensure people received good health care support.
Staff could explain each person’s care needs and how they communicated these needs. People we spoke with and their relatives told us that staff had the skills and approach needed to ensure people were receiving the right care.
We saw that staff respected people’s right to privacy and to be treated with dignity. Feedback form the people we spoke with on the inspection was positive regarding this aspect of care.
All family members and people spoken with felt confident to express concerns and complaints. Issues were dealt with and the service was responsive to any concerns raised.
The registered manager and the two deputy managers could talk positively about the importance of a ‘person centred approach’ to care. Meaning care was centred on the needs of each individual rather than the person having to fit into a set model within the service. It was clear that the service was meeting standards outlined in current good practice guidance including ‘Registering the Right Support’.