Background to this inspection
Updated
11 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
Two inspectors carried out this announced inspection on 2 and 3 August 2018. We gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to enable the service time to arrange for a ‘best interests’ decision about us visiting people.
Before our inspection the provider completed a Provider Information Return (PIR). This 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 looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority. We observed care and support people received when we visited people in their homes.
We looked at records in relation to five people’s care and spoke with 11 people who used the service, and two people’s relatives after the inspection by telephone and email. We also spoke with the registered manager and two service managers and we also spoke with eight care staff. We also looked at records relating to the management of the service, four staff recruitment records, training, and systems for monitoring the quality of the service.
Updated
11 December 2018
United Response provides care and support to people living in a supported living setting, so that they can live in their own home as independently as possible. People’s care and housing is provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
This announced inspection was started on 2 August 2018 and we visited people who used the service in their own homes. We gave the service 48 hours’ notice of the inspection site visit because some of the people using it could not consent to a home visit from an inspector, which meant that we had to enable the service time to arrange for a ‘best interests’ decision about us visiting or meeting people.
On the day of our inspection, there were 60 people being supported with personal care by the service.
During our last inspection in July 2015 the service was rated as good in all the key questions and good overall. At this comprehensive inspection, which we carried out on 2 August 2018 we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. Because the rating remains Good, this inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a long standing registered manager. 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.
Some people shared a house with other people who use the service and others lived individually. The registered manager oversaw the running of the service, and each individual shared house had a service manager.
The service continued to be well led; the registered manager was organised and knowledgeable about the people being supported and was well supported by the providers of the service. People, their relatives and the staff told us that the registered manager was open, supportive and had good management skills. There were robust systems in place to monitor the quality of service the providers offered people.
We saw examples of positive and caring interaction between the staff and people supported by the service, people were treated with kindness and respect. People were able to express their views and staff listened to what they said, respected their views and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.
People and their relatives told us that they still felt safe using this service. People were protected from bullying, harassment, avoidable harm and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. Staff clearly understood their responsibilities to raise concerns and there were arrangements in place for reviewing and investigating incidents when things went wrong. Staff told us they would not hesitate to report any suspicions they had about people being abused.
Risks were assessed and steps had been put in place to safeguard people from harm without restricting their independence unnecessarily. Risks to individual people had been identified and action had been taken to protect them from harm.
Staffing levels were sufficient to keep people safe and staff continued to be safely recruited which helped protect people from harm. People continued to be supported to manage their medicines in a way that ensured that they received them safely and at the right time. There were also appropriate infection control practices in place.
People’s needs assessments were detailed and they received effective care in line with current legislation from staff who had the knowledge, qualifications, skills and experience they needed to carry out their roles.
The management and staff were a strong team and worked well together to ensure that people received consistent person-centred care when they used or were supported by different services. Staff still asked people for their consent before they supported them in line with legislation and guidance.
Caring and supportive staff offered advice to people to help them make healthy decisions around food and supported them to eat and drink enough to maintain a balanced diet. People were also supported to maintain good health and gain access to healthcare services when they were needed.
People received care that was personalised to them and responsive to their needs. Although people told us that they rarely needed to complain, we saw that the service listened to people’s experiences, concerns and complaints. They continued to take action to investigate their complaints, learn by their mistakes and make any changes needed to avoid them happening again.