About the service Next Stage – St Paul's offers support to people living independently within their own flats situated in St Paul's church, Bury. People are supported to develop their independent living skills as well as maintain their own tenancy. Staff are available throughout the day and night time; hours of support vary depending on the assessed needs of people. At the time of our inspection there were 15 people using the service.
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.
People’s experience of using this service and what we found
The purpose and focus of the service needed to be re-established as well as improvements in the quality and safety of support. It was felt a period of implementation and review was needed to help reduce risks and provide confidence in the new service model.
Following conclusion of two recent safeguarding investigations the service has been asked to provide assurance that systems are in place where people have specific support arrangements, so they are kept safe.
Risk management plans and support files were not sufficiently detailed, reviewed and updated to reflect the current and changing needs of people, helping to minimise potential risks to people and others.
The admissions and assessment process was under review so only those people who can be effectively and safely supported will be offered a placement at the service. To assist this, specific areas of training were to be provided and ‘matching’ of people and staff to help provide more structured and effective support.
People spoke positively about the support they received and their relationships with staff, who were described as ‘friendly but professional’. Whilst people’s routines had been impacted on due to the pandemic, alternative activities and opportunities were being explored.
Staff said there was good communication and teamwork. The new manager was said to be approachable, responsive and supportive of the team.
Clear systems were in place with regards to the management of people’s medication. Training and assessments of competency were completed to check staff understood their responsibilities. Where shortfalls had been found through the audits and checks, appropriate action had been taken.
Systems and process to help minimise the risk of cross infection were in place. Staff used personal protective clothing when supporting people as well as additional cleaning within the building.
The manager maintained a record of any issues or concerns brought to their attention and any action taken where necessary.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published November 2019).
Why we inspected
We received concerns in relation to the safe care and treatment of people, particularly in relation to risk management. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence the provider needs to make improvement. Please see the safe, responsive 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 Next Stage – St Pauls on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to the risk management, support plans and areas of governance at this inspection.
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.
Please see the action we have told the provider to take at the end of this report.
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.