Background to this inspection
Updated
25 December 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
This inspection was announced. We gave the service 20 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
The inspection was carried out by one inspector and an 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 six ‘supported living’ settings, 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.
The service had two managers registered with the Care Quality Commission who shared a responsibility to manage the six supported living homes. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
What we did before the inspection
We looked at information we held about the service, including notifications they had made to us about important events. We asked the service to complete a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We visited the agency office on 18 October. On 30 October and 5 November, we visited two of the supported living homes. We spoke with five people about their experience of the care provided to them. We received feedback from seven relatives. We talked to the registered managers, two service managers and two staff members working for this service.
We also looked at a range of records that included people’s care plans and staff files in relation to their recruitment, training and supervision.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at data relating to staff training, risk management and auditing systems.
Updated
25 December 2019
About the service
Royal Mencap Society - Domiciliary Care Services - South London is a supported living service providing personal care to 25 people, many of whom have learning and physical disabilities, autistic spectrum disorder and mental health needs. People supported by the provider were aged between 30 and 65 at the time of the inspection.
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
Quality assurance processes were in place, but required reviewing to ensure their effectiveness. This included monitoring of staff fitness for their role. Staff had guidance required for their role, but they were not always provided with the necessary mandatory training courses to meet their role expectations. We made recommendations about this.
Although people had comprehensive risk management plans in place, information was not always available on how likely the risks were to occur. There wasn’t always enough staff to support people with going out on the activities of their choice. Records related to people’s end of life wishes and mental capacity assessments were not always completed appropriately. The management team told us that these areas of concern would be addressed immediately. We will check their progress at our next comprehensive inspection.
Pre-employment checks were carried out before staff were recruited by the provider. Staff reported their concerns as necessary if they noticed people being at risk of abuse or when incidents and accidents took place. People had support to manage and store their medicines safely.
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. Staff supported people to meet their health needs as necessary which supported their well-being. People had a choice to prepare their meals separately from their housemates and were assisted with their meal preparations as necessary.
People received excellent care from staff who were open and compassionate towards their role responsibilities. They provided emotional support which enabled people to follow their religious believes and express themselves in the way they wanted to. There was a comprehensive level of support provided for people to help them plan their care and the support they required to achieve their desirable outcomes. People were encouraged to use resources available in the community, so they could lead independent and fulfilling lives.
Care plans were individualised and met the needs of people using the service. Complaints received were investigated appropriately and according to the provider’s policies. Family members were asked for regular feedback, so the management team could improve the service and the experience of people.
The service followed the provider’s set values which promoted open and transparent culture within the staff team who supported people with their everyday needs. There was a supportive leadership at the service who aimed to encourage staff to develop in their role, so they could provide a person-centred care for people. The service used external resources to keep them up-to-date with the changes taking place in legal requirements.
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 (published 21 April 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.