Background to this inspection
Updated
3 December 2022
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 Health and Social Care Act 2008.
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
The inspection was carried out by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. The manager in post had submitted an application to register. Since our inspection, the manager’s application has been processed and there is now a registered manager in post.
Notice of inspection
We gave a short period of notice of the inspection because some of the people using the service could not consent to a home visit from an inspector. This meant we had to discuss the inspection with the manager beforehand, so they could prepare people for our visit.
Inspection activity started on 13 September 2022 and ended on 03 October 2022. We visited the service on 13 September 2022 and 14 September 2022.
What we did before inspection
We reviewed information we had received about the service since the current provider took over the service on 26 November 2020. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with three people using the service, one of which was able to share their experiences of using the service. We also spoke with two relatives of people using the service. We spoke with the registered manager, the regional manager and four care workers. We reviewed a range of records, including four people's care records, three staff files and various records relating to the management of the service. After the inspection we continued to seek clarification from the provider to validate evidence found.
Updated
3 December 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Upper Selsdon Road is a supported living service providing personal care and support to up to 9 people with learning disabilities and/or autistic people.
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
Right Support
The service did not always sufficiently assess all people and staff for the risk of COVID-19 infection. This could put some people and staff at an increased risk of potential harm. We have made a recommendation about preventing and controlling infections. The service had not always worked in accordance with the Mental Capacity Act 2005. This meant the provider had not always supported people to make decisions following best practice in decision-making.
The service supported people to have the maximum possible choice, control and independence. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to pursue their interests and achieve their aspirations and goals.
The service worked with people to plan for when they experienced periods of distress.
The service gave people care and support in a clean environment. People had a choice about their living environment and were able to personalise their rooms. People benefitted from an interactive and stimulating environment.
The service made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go. Staff supported people to take part in activities and pursue their interests and to stay in touch with people important to them.
Staff enabled people to access specialist health and social care support in the community. Staff communicated with people in ways that met their needs. Staff supported people with their medicines in a way that achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care
Staff promoted equality and diversity in their support for people. They understood people's cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. The service worked well with other agencies to do so.
People could communicate with staff and understand information given to them because staff understood their individual communication needs. People who had individual ways of communicating could interact comfortably with staff and others involved in their care and support because the staff had the necessary skills to understand them.
People's care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People received care that supported their needs and aspirations and was focused on their quality of life.
People could take part in activities and pursue interests that were tailored to them. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Culture
The provider had not always sufficiently assessed, monitored and improved the quality of services provided. This meant the provided had not always identified the concerns we found and where they had identified concerns, action to address these had not always been taken in a timely manner. Staff training was not up to date. Some training for staff was overdue and the provider had not always taken action in a timely manner when training requirements were not met. Some relatives we spoke with felt the provider had not sufficiently involved them in the care of their loved ones. We have made a recommendation about engaging and involving people's families in their care and support.
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
Staff placed people's wishes, needs and rights at the heart of everything they did. People were involved in planning their care. Staff valued and acted upon people's views.
People's quality of life was enhanced by the service's culture of inclusivity and empowerment. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support, right care, right culture.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.