We carried out a review of the data available to us about 1-3 The Courtyard, Unit 24 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 1-3 The Courtyard, Unit 24, you can give feedback on this service.
1-3 The Courtyard, Unit 24 is a domiciliary care service providing personal care to people living in the Bolton area. The service provides support to people with a learning disability and autistic people as well as people with mental health needs. 1-3 The Courtyard, Unit 24 also provides a supported living service at one separate location.
At the time of our inspection there were 32 people using the domiciliary care service and 6 people using the supported living service. 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. At the time of the inspection there were 15 people receiving personal care in total.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People had a choice about their living environment and were able to personalise their flats. Staff supported people with their medicines in a way which promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing. People had access to education and employment where this was identified as their preference.
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/ did not support this practice.
Right Care:
People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care, abuse, and harm. The provider had robust safeguarding systems which included working alongside other agencies when things went wrong. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests tailored to them. The provider gave people opportunities to try new activities which enhanced and enriched their lives.
Right Culture:
People received good standard of care, support, and treatment because trained staff and specialists could meet their needs and wishes. Staff placed people's wishes, needs, and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care. Managers ensured risks of a closed culture were minimised so people received support based on transparency, respect, and inclusivity.
People told us they felt safe and knew how to raise concerns. Staff assessed health and safety risks and supported infection prevention and control processes. There were enough staff to meet peoples' needs and recruitment processes were ensured staff were suitable to work with vulnerable people. Peoples' health and nutrition needs were supported, and staff were aware of their responsibility to promote peoples' rights. Systems were in place to monitor quality and safety, and the provider sort regular feedback from people to improve their support.
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 20 July 2017)
Why we inspected
This inspection was prompted by a review of the information we held about this service.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 1-3 The Courtyard, Unit 24 on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The service has an office in Bolton and provides personal and nursing care to people who have complex care needs. The service supports six people living in a supported tenancy house. In addition, care is provided to people living in their own homes via an outreach placement.
The service had a registered manager in place. 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 recruitment system was robust and helped ensure staff were suitable to work with vulnerable people. Staffing levels were sufficient to meet the needs of the people who used the service.
Safeguarding issues were recorded and reported appropriately. Staff undertook regular training in safeguarding and demonstrated a good understanding of how to recognise, record and report any concerns.
Accidents and incidents were recorded appropriately and general and individual risk assessments were in place and reviewed regularly. Health and safety records were complete and up to date and medicines were managed safely at the service.
There was a thorough induction programme and a training programme was on-going to help keep staff skills and knowledge up to date. Staff demonstrated a good understanding of their roles and responsibilities.
Care files included relevant assessments and evidenced good communication between the service and other agencies.
The service were working within the legal requirements of the Mental Capacity Act (2005). Staff had an understanding of the principles of the MCA.
We observed staff at the supported living service and saw that they interacted in a kind and friendly manner. People who received care in the community told us they were treated with the same respect and courtesy.
There was a service user involvement policy and procedure. Many of the documents included in people’s care files were produced in easy read format to make them more accessible to people who used the service.
Care plans were person-centred and included a range of health and personal information. People’s preferences, likes, dislikes and interests, goals and aspirations were documented.
People were supported to access a range of work, college and social activities. The service had an appropriate, up to date complaints policy and complaints were followed up as required.
People told us the management at the service were always approachable and supportive. Staff supervisions and appraisals were undertaken on a regular basis.
There were a number of regular audits undertaken at the service and the results were analysed to help drive continual improvement in care delivery.