Background to this inspection
Updated
7 September 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. 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.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
This service provides care and support to people living in four ‘supported living’ settings, 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. A manager appointment had been made and application to register was CQC was in the process of being completed. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on the 8 August 2019 and ended on the 13 August 2019. We visited the office locations on 8 August. On 13 August we visited people living in their own homes as well as meeting with staff.
What we did before the inspection
We reviewed information we had received about the service since registering with the CQC. We sought feedback from three local authorities involved with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. No issues or concerns were raised with us.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We also reviewed information we held about the service, including notifications the provider had sent us. A notification is information about important events which the provider is required to send us by law. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service about their views and experience of the care and support provided and 11 members of the staff team; two support staff, two team leaders, four training and human resources staff, the personalisation lead, a quality performance manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with a visiting health care professional.
We reviewed a range of records, including multiple medication administration records (MAR’s), care records staff personnel files, training records as well as information relating to the health and safety and management and oversight of the service.
Updated
7 September 2019
About the service
Next Stage Crostons Court offers support to people living in four supported living properties located in Bury, Rochdale, Urmston and Blackburn. People are supported to develop their independent living skills as well as maintain their own tenancy. Individual staff teams are based at each location with staff available throughout the day and night time. At the time of our inspection there were 30 people using the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People spoke positively about their experience. People said they felt safe and trusted the staff. People said they were offered lots of encouragement and support to follow a lifestyle of their own choosing. One person talked about how the service was now supporting them to move to more independent accommodation. Whilst others spoke about how they no longer felt socially isolated and were now learning new skills as well as developing friendships with other people.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
There was great emphasis on providing a ‘personalised’ service for people. Designated staff were available to support people to explore social, education and employment opportunities helping to promote their independence, increase community presence as well as reduce social isolation.
The service had recently gone through a period of restructure. All staff spoken with felt this had been well managed, with positive improvements to the service including open and inclusive management who now ‘listen’ to staff.
A review of records, feedback received, and our observations showed sufficient numbers of staff, that had been safely recruited, were available to respond to people’s requests for support. This was available on a planned and informal basis.
The service focused on the personal development and support of staff, providing a wide range of opportunities based on their individual learning needs as well as the needs of people they supported. Staff were enthusiastic about their role and the improvements being made. They said the service was well run, there was good team work and they were effectively supported in their role.
Detailed assessments were completed, which were then used to inform the development of people’s support plans and risk assessments. These focused on minimising areas of risk whilst enabling people to remain as independent as possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Systems were in place to support people with the safe management and administration of their prescribed medicines. People had access to a range of health care support where needed.
Varying levels of support were provided in areas such as budgeting, shopping, cooking and housekeeping, encouraging people to continually develop their independent living skills.
Good working relationships had been developed with the landlord to ensure individual properties were maintained. Relevant health and safety checks including fire safety were completed to make sure people and the premises were kept safe.
There was evidence of on-going management and oversight of the service. Regular audits and checks were completed to monitor and review the standards of care. Any themes or patterns were explored, such as accidents or incidents, an action plan was put in place to evidence improvement to be made.
System were in place for the recording and responding to any safeguarding issues or complaints and concerns. These were responded to appropriately.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 6/2/2019 and this is the first inspection.
Why we inspected
This was a planned inspection based on our inspection programme.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
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 we receive any concerning information we may inspect sooner.