Archived: Walsingham Support - Supported Living North Cumbria C1

Walsingham Support North Cumbria is a supported living service providing personal care to 20 younger and older adults with a learning disability and/or associated conditions in their own homes.

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.

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 were supported in their own homes in smaller groups.

People’s experience of using this service and what we found

Some of the people who used the service had complex needs and they did not express their views verbally about the service. During the time we spent with people we saw they appeared comfortable with staff.

Staff supported people to ensure they received care that helped them develop. Staff received training and support to help them carry out their role.

Some people displayed distressed behaviours. Not all staff had completed training in this area before supporting people. We have made a recommendation about this.

Most people and relatives said they felt safe and were positive about the care provided. We have made a recommendation that staffing capacity is kept under review to ensure people are kept safe and person-centred care is provided.

Staff knew the people they were supporting well. Detailed care plans were in place that documented how people wished to be supported. Staff had developed good relationships with people, were caring in their approach and treated people with respect.

Information was accessible to involve people in decision making about their lives. Most 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 for people.

Some areas of improvement were required to strengthen the governance system. Improvements had been made as a result of recent safeguarding incidents raised due to the management of some behaviours that challenge, but they needed to be actioned in a more timely way.

As a specialist service, moving forward, more robust systems need to be in place to successfully manage such behaviours, including people’s transition to the service, to ensure people enjoy a good quality of life and keep all people safe.

Regular audits and checks were carried out. These however, had not identified the issues we had found at inspection to ensure care and support was provided safely and in a person-centred way.

There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns.

People were supported to enjoy activities in the community and to go on holiday.

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.

People and staff were positive about the management of the service and felt valued and respected.

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 28 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection in January 2015 the service was rated as Good. At this inspection we found that the service remained Good.

A registered manager was 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 registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the agency. Our observations and discussions with staff and people who worked for the agency confirmed there were sufficient staff to care for and support people, some having complex needs.

Health care needs were met through peoples’ GPs and the district nursing service when required. We saw that medicines were administered safety and all the records were up date and audited regularly. All staff had completed training in the safe handling of medicines.

Observations during our inspection evidenced people were given choices about how they wanted to be supported and live their lives. Opportunities were given to people to go out into the community, visit their families and go on holiday.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice. This helped to protect the rights of people who were not able to make important decisions themselves.

Support staff knew the people they cared for well. They provided a caring environment for people to live in. People were treated in a dignified manner with their privacy upheld at all times.

Personalised care plans were in place in a format that was suitable through pictures and symbols as well as writing. Care plans were person centred and regularly reviewed to ensure they reflected people's current needs and preferences

People who used the service had a voice through regular visits by the members of the management team to each of the houses. Procedures were in place to investigate and respond to any concerns raised.

There were effective monitoring systems in place to assure quality and identify any potential improvements to the service. This meant people benefited from a constantly improving service.

"I am quite happy. I go out shopping and I go to church and I help out around the house. I love the staff."

"We are happy with the care...we get an early call and all the staff are very good."

"They gave us support ...and helped me through the death of my partner...they are wonderful."

"Since I moved to these flats my life has completely changed and I now have a little job and I go out more and I am much more independent."

We looked at the way any allegations of harm and abuse were managed. We had evidence to show that the management team of this service understood their responsibilities. All of the staff who worked in the service had received training in safeguarding.

We checked on the records of medication and found that these were in order. The management team completed regular audits of medicines managed on behalf of people.

We had evidence to show that staff were suitably trained and supported to do their job.

We look at a wide variety of records and we found these to be kept securely, were up-to-date and detailed.

People who used services were helped with the kind of physical, psychological and psychiatric care necessary for their needs. They were also given lots of encouragement to be as independent as possible and to have the kind of varied and fulfilling lifestyles they wanted.

People told us:

"Most of the staff are really good...they let me do as much as I can for myself."

"The staff conform to what I ask for...I asked for mature staff and they are! They understand what I need...I have the kind of service I want."

The main office for the service was suitable but we asked the provider to consider whether they needed to register some of the other offices they have in the Carlisle area as separate locations.

Staff were recruited appropriately and all necessary checks completed so that vulnerable people were protected from harm. We also had evidence to show that there were enough skilled and experienced staff to provide care to people.

People told us:

"New staff shadow a more experienced member of staff.They are taught how to support me and they learn fast."

"New staff do lack experience...but they get trained. The manager brings new people up to speed quickly."

Complaints were managed appropriately.