We carried out a review of the data available to us about Support for Living Limited - 26 Stockdove Way on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Support for Living Limited - 26 Stockdove Way, you can give feedback on this service.
About the service
Support for Living Limited - 26 Stockdove Way is a care home for up to eight adults with a learning disability and autism. At the time of our inspection, seven people were living at the service.
People’s experience of using this service and what we found
Right Support
Staff enabled people to access specialist health and social care support in the community. They supported people to play an active role in maintaining their own health and wellbeing. People were supported with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff communicated with people in ways that met their needs. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People were supported to have the maximum possible choice, control and independence be independent and they had control over their own lives.
Right Care
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply this training. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks
Right culture
People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. 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. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity .
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 21 November 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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 re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service and what we found
Relatives and adult social care professionals told us people were safe. However, we found medicines were not always managed in a safe way.
There were systems in place to monitor the quality of the service and recognise when improvements were required. These were not always sufficiently robust to have identified and addressed the issues we found at this inspection.
People had personalised care and risk management plans in place. These reflected people’s care and support needs and preferences. We have made a recommendation about people’s risk management plans in relation to supporting people with mobility issues.
There were systems and processes in place to protect people from the risk of harm. The provider recruited staff using safe recruitment processes. There were arrangements in place for preventing and controlling infection. The service worked with other agencies to make sure people received joined up care.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care maximised people’s choice, control and independence. People’s care was person-centred and promoted their dignity, privacy and human rights. The ethos, values, attitudes and behaviours of the managers and care staff ensured people
using services led inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 5 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
The inspection was prompted in part by notification of a specific incident wherein a person using the service sustained a serious injury. The information the CQC received about the incident indicated concerns about supporting people with mobility issues to move safely. As a result, we undertook a focused inspection to review the key questions of safe 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 remains requires improvement. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe 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 Support for Living - 26 Stockdove Way on our website at www.cqc.org.uk.
Enforcement
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. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to providing safe care and having effective systems in place to monitor and improve the quality of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
•Visitor information was clearly displayed at the entrance to the home. Staff explained the infection control protocol to visitors, so they knew what action to take to reduce the spread of the infection. In the warmer months the staff had supervised visitors when garden visits had taken place.
•As the weather became colder alternatives to relatives visiting in person where being supported. This included for example, telephone and video calls.
•There were adequate supplies of PPE and staff were using PPE in a safe manner, during the inspection.
•The registered manager and staff were supporting people to socially distance in the home. They provided accessible information about COVID 19 to people and had supported two of them to wear PPE when attending hospital visits.
•The registered manager had undertaken risk assessments for people and staff. They had reviewed factors which placed people at a higher risk. They had worked with a multi-disciplinary team to identify measures to monitor health and provide safe care and treatment.
Further information is in the detailed findings below.
Support for Living Limited – 26 Stockdove Way is a care home providing personal care and accommodation for up to seven adults who have learning disabilities or autistic spectrum disorder.
The care home accommodates people in one adapted building. 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
We found some risk had not been mitigated when we visited the service. One person did not have a personal emergency evacuation plan in place and there had not been a fire drill at night time to ensure staffing levels were adequate enough to meet people’s support needs in the event of a fire. One of the night staff had not received training about how to use an evacuation chair. Whilst the provider had been working with the landlord and a fire consultancy agency, we did not find all the necessary actions had been taken in a timely manner.
Medicines were administered and stored appropriately but we found the reasons why some medicines were in use was not always documented. There was a concern therefore staff might not realise the importance of specific medicines.
People had person centred plans and contained good guidance for staff. Most seen were reviewed on a regular basis. One person still had the care plan written when they lived at another service. However, staff had just commenced a new electronic plan to reflect their current support needs.
The registered manager assessed staffing levels. Relatives told us staff were often very busy but felt people were well looked after. Staff confirmed the management team was “hands on” at times to support them.
People who were able, told us they liked the staff and felt safe at the home. Relatives and professionals told us people were well cared for by staff; some of whom had known them for many years. They described that people’s eyes, “light up” when some very familiar staff were on duty. We observed people to be supported in a proactive and responsive manner.
Staff ensured people had access to health and social care professionals. A health professional told us staff asked their advice and followed recommendations and guidelines.
Staff told us they received appropriate training and felt well supported by the management team. Although we found that at least one member of staff needed further training regarding fire safety. They found the registered manager and deputies approachable as did people’s relatives who felt they could raise a complaint or issue.
Staff communicated with people in ways they could understand and were observed to be respectful and promoted people’s dignity.
People were supported to attend a wide variety of activities that reflected their preferences and were supported to access the local community to meet and maintain relationships with family and friends.
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.
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.
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 some restrictive intervention practices in the form of medicines as a last resort, in a person-centred way, in line with positive behaviour support principles. The provider had worked successfully with their own behavioural support team and health care professionals to reduce the use of these medicines and incidents of behaviour that challenged the service had also reduced.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good on the 14 and 15 February 2017 (Published 29 March 2017.)
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report. The provider took immediate action to address the concerns we found during our inspection.
Enforcement
We found breaches of two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and good governance. You can see what action we have asked the provider to take within our table of actions.
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.
26 Stockdove Way is a care home that provides accommodation and care for up to eight adults with a learning disability and/or a physical disability. At the time of our visit there were eight people using the service. The accommodation was laid out over two floors. Each person had their own bedroom and could access the communal facilities such as a lounge, dining room, kitchen and garden. The first floor could be accessed by a lift.
The service had a registered manager who had been in post since November 2016. 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 a good understanding of how to manage the service and kept up to date with current good practice and required regulations.
As we found at the last inspection, the service protected people from harm, neglect and abuse.
The service regularly assessed and reviewed risks to people's health, wellbeing and welfare and had procedures in place to identify and manage these risks.
The service had recruitment procedures which they followed to ensure only suitable staff were appointed to work with people who used the service.
Staffing levels at the service were sufficient to meet people's needs.
People received their medicines safely and staff were sufficiently trained to administer medicines safely.
Staff had the knowledge and skills they needed to carry out their roles and responsibilities. They received regular training and support to help them carry out their roles effectively.
The service was working within the principles of the MCA, and conditions on authorisations to deprive a person of their liberty were being met. Staff supported people to maintain a balanced diet that reflected their nutrition needs as well as cultural and religious preferences.
The service worked closely with the healthcare professionals involved with each person's treatment and care to ensure their needs were being met.
People received care that was compassionate and caring and reflected their care needs and preferences. People’s needs were assessed and the information was used to formulate individual care plans.
The service recognised the importance of family participation in the lives of people using the service. Relatives were welcome to join people at daily activities and, where appropriate, they took an active part in reviewing and planning of care for their relatives.
The service supported people in a dignified and respectful way. Staff provided personal care in a way that respected peoples’ privacy as well as their gender and cultural needs.
The provider had a complaints procedure in place. It was available in a pictorial format to make it more accessible to people using the service.
The service had systems in place for handing over information between the staff to ensure they were familiar with any changes at the service.
Staff told us they felt comfortable working at the service and felt supported by the management team.
As with the previous inspection, there were systems in place to assess and monitor the quality of the service.
This inspection took place on 4 and 5 November 2014 and was unannounced. At the last inspection on 21 and 22 August 2013 we found the service was meeting the regulations we looked at. 26 Stockdove Way is a care home which provides accommodation and care for up to seven adults with a learning disability and/or a physical disability.
At the time of our visit there were seven people using the service. The accommodation is laid out over two floors. Each person had their own bedroom and can access the communal facilities such as a lounge, dining room, kitchen and garden. The first floor can be accessed by a lift.
The service did not have a registered manager. The previous registered manager had left the service in July 2014. We had been informed about this by the provider in accordance with their responsibility as set out in our regulations. 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.
Arrangements were in place to safeguard people against abuse or harm and staff understood how to safeguard the people they supported. Relatives we spoke with told us their family member was safe whilst at the service.
People were comfortable and staff engaged with them in a professional and caring manner. Risks to people’s health and wellbeing had been assessed and staff knew how to manage these to keep people safe from harm.
There were enough staff on duty to meet people’s needs. Recruitment was on going to fill staff vacancies. People were given their prescribed medicines and medicines were reviewed regularly to ensure their ill health was managed.
People were cared for by staff who received appropriate training and support to meet their needs.
Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences. Staff worked with other healthcare professionals to support people with their health needs. People were supported to eat and drink safely.
Staff had a good understanding of the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Where restrictions were in place people were assessed and decisions had been made in their best interest. Appropriate procedures were followed so that people’s human rights were upheld. People were involved in decisions about their care and how their needs would be met.
People were supported to undertake outings and activities of their choice. Relatives told us the staff were welcoming and were confident to raise any concerns they had. The management team was accessible and open. People were encouraged to maintain relationships that were important to them.
There were systems in place to monitor the safety and quality of the service that people experienced. People and their relatives/advocates were involved in the service. They had participated in the recruitment of the manager. Where people were not able to make their views known their relatives and friends were consulted on their behalf.
The previous inspection visit in April 2013 had identified a need to improve care records and risk management plans, the management of people's medicines and a need to improve quality assurance monitoring in the home. During this inspection we found that the provider was compliant with all of the outcome areas we assessed.
People's care records were up to date. Medicines were being managed safely and people were receiving the medicine they required.
Regular audits were carried out to monitor the quality of service provision and action was taken to address issues identified.
We observed that staff engaged positively with people and showed respect in their interactions. Comments we received from relatives included 'staff have a very good understanding of my family member's needs' and 'the staff know the best ways to communicate with people'.
Relatives told us they were involved in developing and reviewing care plans. The majority said that they were happy with the care and support that was provided. Risk assessments were not up to date and people were at risk of unsafe or inappropriate care.
The arrangements for the management of medicines were not always effective in protecting people against the risk associated with medicines.
Staff received training and support to make sure they were competent and skilled to care for people.
Effective systems to regularly assess and monitor the quality of services provided to people were not in place.
We found the majority of staff were pleasant and courteous towards people and made different attempts to engage people in activities. However, we did identify occasions when the staff did not acknowledge people and where they did not offer them refreshments, despite the staff sitting next to them having a drink. We also identified risks to people and staff within the environment. We have made the provider aware of these.
People were not able to speak directly with us about the care they received. Therefore we spoke with relatives and received feedback from a health professional.
We also carried out a structured observation using a tool known as a Short Observational Framework For Inspection (SOFI 2). This involved observing the care people received and the interactions between people and staff.
We observed that staff interacted with people in a calm and sensitive way. Staff explained the care people were going to receive, for example, when people were going to be moved using a hoist from a chair to a wheelchair.
We saw that staff appropriately supported people with eating at the person's pace while interacting with them.
People were given choices about the activities they took part in and the food and drinks that they wanted. Relatives also confirmed that people had choices in their everyday lives.
Staff had an understanding of people's individual needs and capabilities and relatives told us that overall staff were friendly and that the team was stable and consistent.
Relatives said that they attended meetings held in the service where they could give their opinions about how the service was run.