Archived: Office S10, Bradshaw Support Limited

Office S10, Bradshaw Support Limited provides care and support to people living in supported living settings. The service specialises in supporting people living with autism or those with a learning disability to live independently in their own homes. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The service was providing different levels of support to 19 people. Not everyone who used the service received personal care. At the time of inspection, only three people were receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and nutrition. Where they do we also consider any wider social care provided.

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

Allegations and concerns around financial abuse had been made against the service, concerning both ex and current staff members. At the time of inspection, there was an active police investigation into these concerns.

People did not always receive safe care and were not always protected against avoidable harm and abuse, The management team were in the process of reviewing their systems and making improvements in these areas.

Improvements had been made to recruitment practices to ensure that every staff member had employment references before starting work.

Communication with the staff team had been poor. The management team had begun to speak with the staff members about improvements that were planned.

Risks assessments and strategies were put in place to reduce the risks.

Staff were employed in sufficient numbers to meet people’s needs.

Where the provider took on the responsibility, people’s medicines were safely managed.

Systems were in place to continuously monitor the quality of the service.

The management were open and honest during our inspection and understood where improvements were required. The provider worked in partnership with outside agencies.

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 Requires improvement (published 02 July 2019) and there were two breaches of regulation. The provider had begun to make improvements, but only a short period of time had passed since the last inspection, and the rating reflects that it will take time to see these improvements embedded in practice and the areas of improvement sustained.

Why we inspected

This inspection was prompted due to ongoing concerns received about financial abuse, information received from the police about their ongoing investigation, the sustainability of the service, and the affect this may have on the safety and wellbeing of the people using the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the Key Questions of Safe and Well-led only. We are continuing to monitor information and make enquiries around these specific incidents, alongside the local authority and the police.

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.

We found no new evidence during this inspection that the risk of harm to people had increased since our last inspection in June 2019.

The overall rating for the service remains Requires Improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Office S10, Bradshaw Support Limited on our website at www.cqc.org.uk.

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.

Office S10, Bradshaw Support Limited provides care and support to people living in supported living settings. The service specialises in supporting people living with autism or those with a learning disability to live independently in their own homes. People's care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The service was providing different levels of support to 19 people. Not everyone who used the service received personal care. At the time of inspection, only three people were receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and nutrition. Where they do we also consider any wider social care provided.

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

The service had a manager who was still registered with the Care Quality Commission but was no longer working for the service due to allegations and concerns around financial abuse.

People did not always receive safe care and were not always protected against avoidable harm, abuse, neglect and discrimination.

Recruitment practices were mostly safe, however one staff member was working for the service without any references from previous employers.

Communication with the staff team was poor. Staff told us they did not fully trust the provider to communicate with them in a fair and respectful manner.

People were not always fully respected.

Risks assessments and strategies were put in place to reduce the risks.

Staff were employed in sufficient numbers to meet people’s needs.

Where the provider took on the responsibility, people’s medicines were safely managed.

Staff received training that enabled them to have the skills and knowledge to provide effective care.

Where the provider took on the responsibility, people were supported to maintain good nutrition and hydration.

Staff encouraged people to maintain their independence.

People and their relatives were involved in the care planning and reviews of people’s care.

Systems were in place to continuously monitor the quality of the service.

The management were open and honest during our inspection, and understood where improvements were required. The service worked in partnership with outside agencies.

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 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 Outstanding. The last report was published 2 March 2018.

Why we inspected

This inspection was prompted in part due to concerns received about financial abuse, staffing levels, staff recruitment procedures and lack of management support within the service. A decision was made for us to inspect and examine those risks. We are continuing to monitor information and make enquiries around these specific incidents, alongside the local authority and the police.

We have found evidence the provider needs to make improvements. Please see the Safe, Caring 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.

The overall rating for the service has changed from Outstanding to Requires Improvement. This is based on the findings at this inspection.

Enforcement

We have identified breaches in relation to safeguarding service users from abuse and improper treatment, and good governance.

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.

At this announced inspection on 18 January 2018, we rated the service as Outstanding.

Office S10, Bradshaw Support Limited provides care and support to people living in 14 supported living’ settings. The service specialises in supporting people living with autism or those with a learning disability to live independently in their own homes. They provide support with personal care, food preparation, managing finances and enabling people to undertake activities in the local community. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

There was a registered manager 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.

People's experiences of care were overwhelmingly positive. They told us they were supported by very kind, caring and compassionate staff that often went the extra mile to provide them with exceptional care. The staff and the management team were extremely passionate about providing people with support that was based on their individual needs, goals and aspirations. We saw that people were at the centre of their care and found clear evidence that their care and support was planned with them and not for them. Each person was treated as an individual and as a result, their care was tailored to meet their exact needs.

There was a strong culture within the service of treating people with dignity and respect. The staff and the management team were always available and listened to people and their relatives/friends, offered them choices and made them feel that they mattered.

The management team were highly committed to ensuring people lived fulfilling lives. The whole focus of peoples care was person centred and focused on promoting peoples independence. Staff worked with people to identify their dreams and aspirations and celebrated people’s achievements.

The service was exceptional at empowering people to have as much control over their lives as possible and to achieve their maximum potential. The staff were passionate about the person-centred approach of the service and it was clear it was run with and for people. Without exception, people spoke positively about their experience of the service and the successes they had been supported to achieve. It was clear the culture within the service valued the uniqueness of all individuals.

People had access to a wide range of activities, which took account of their personal preferences and were tailored to their individual needs. Staff went to exceptional lengths to encourage people to attend activities and find employment y that would enhance their health and well-being.

People continued to receive safe care. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff understood how to prevent and manage behaviours that the service may find challenging. Effective recruitment processes were in place and followed by the service and there were enough staff to meet people’s needs. People received their medicines safely and as prescribed. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service

People’s needs and choices were assessed and their care provided in line with up to date guidance and best practice. The care that people received continued to be effective and meet their needs. There were sufficient staff, with the correct skill mix, on duty to support people with their care. Staff received an induction process when they first commenced work at the service. In addition, they also received on-going training to ensure they were able to provide care based on current practice when supporting people.

People received enough to eat and drink and staff gave support when required. People were supported by staff to use and access a wide variety of other services and social care professionals. The staff had a good knowledge of other services available to people and we saw these had been involved with supporting people using the service. People were supported to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care. People's consent was gained before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

The service had a positive ethos and an open culture. The management team were positive role models that encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement. People and relatives were involved in quality checks of the service to ensure people received a high quality service driven by improvement.