We carried out a review of the data available to us about Supported Living Service 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 Supported Living Service, you can give feedback on this service.
The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.
At our last inspection in April 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Why the service is rated Good.
Feedback provided from people included “I’m safe”, “Staff know me and keep me safe when needed” and “They keep me safe and warm.” People told us that they liked the staff that supported them and thought they were caring. Their comments included, “Staff are nice”, “They [staff] are kind when I get upset” and “I like them and they like me, we have fun.”
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Procedures were in place to protect people from abuse and staff had a good understanding of these procedures. People's medicines were safely managed to ensure that they received their medicines when they should. Safe recruitment procedures remained in place to help ensure that only people suitable for the role were employed to deliver care and support to people.
People told us that staff always asked their permission prior to carrying out any activity or task. Staff had a clear understanding of a person centred approach to care by ensuring that people’s consent was sought at all times and their lifestyle choices were adhered to. There had been a delay in the registered provider applying to the Court of Protection for the renewal of Deprivation of Liberty (DoLS) authorisations in place under the Mental Capacity Act. This had been identified by the registered manager and was addressed at the time of this inspection.
Assessments of people’s needs took place on a regular basis and were used to identify any new or changes to people’s needs and wishes. People told us they were involved in assessments and reviews of their care needs. Care plans contained detailed information that staff needed to know to ensure assist people with their care and support in the way they preferred. People's care and support continued to be delivered by staff who received regular training and supervision for their role.
Staff supported people in a manner that promoted their independence by maintaining and developing new skills. Staff continued to show a good knowledge and understanding of the people they supported.
People continued to be fully involved in planning their own care and support and making decision about how their needs were met. With the support of the staff team, people set goals that they wished to achieve. Each person had their own care plan which detailed their needs, wishes, took into account people’s lifestyle choices, views and preferences . Each plan clearly detailed what support people needed and how staff were to delivered this support as the person wanted. A complaints procedure was in place which people had access to.
The registered manager continued to oversee the service provided to people and demonstrated a thorough knowledge of the legislation in place to provide safe, effective care to people using the service. Staff spoke positively about the support they received from the management team. Staff told us they were proud and enjoyed working at the service as it was well managed. Policies and procedures remained in place to offer best practice guidance and advice to staff in relation to their role. The service had access to the registered provider’s human resource and health and safety departments that provided up to date guidance and support.
The Supported Living Service is registered to provide personal care for adults with learning disabilities and other complex needs living in their own homes. There were 53 people being supported on the days of inspection.
The service had a registered manager in place who had been registered with the care Quality Commission since August 2015. 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 were supported to take their medicines by staff that were appropriately trained. People received care and support from staff that knew them very well, and had the knowledge and skills to meet people’s individual needs. People told us staff always treated them with kindness and promoted their choices regarding their care, support and the activities they participated in. People spoke very positively about staff, their comments included, “Staff look after me, I like them” and “Staff do everything I need”.
People were supported to live a full and active life, offered choice and staff had safeguards in place to support people to experience outings and for activities to go ahead. Risk assessments were regularly reviewed and also when people’s needs changed and the staff approach was flexible to allow for changes in circumstances. The staff ensured people were protected from the risk of harm.
Staff were trained in safeguarding adults and understood how to recognise and report any abuse. The service had policies and procedures in place that informed staff of how to keep people safe and these were followed.
Staffing ratios were in place to meet people’s assessed needs and were responsive to people’s changing needs and preferences. This allowed for people to go away on holiday if they chose and to undertake activities of their choice.
People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.
People’s risks were anticipated, identified and monitored. Staff managed risk effectively and supported people’s decisions, so they had as much control and independence as possible.
Care plans provided staff with clear direction and guidance as to how to meet people’s individual needs. The service was flexible and responded to people’s needs. People told us the staff met all their needs.
People knew how to raise concerns and make complaints. People who had raised concerns confirmed they had been dealt with promptly and satisfactorily. We saw records that demonstrated the complaints procedure had been followed.
There was a management structure within the service which provided clear lines of responsibility and accountability. There was a positive culture within the service and the management team provided strong leadership and led by example. Staff said “I feel well supported by the company” and “We are a good team and everyone from the manager, assistant manager, team leaders and support staff are supportive”.
There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The registered manager, assistant manager and team leaders were visible in the service. They regularly visited people in their own homes and sought their views about the service.
The Supported Living Service provides support to adults with learning disabilities and other complex needs in their own homes in St Helens. At the time of the inspection, 55 people were being supported by the service within 33 properties. A number of the people using the Supported Living Service lived at Sorogold Close, which is a development of purpose built bungalows for people living with complex care needs that was built in 2012. For the people, living at Sorogold Close there was a 24 hour on call emergency service available on site.
People using the service were safe because staff had received training on how to recognise signs of abuse and possible harm and knew what to do if they had any concerns. Staff were proactive in reviewing incidents or accidents to reduce the chance of reoccurance. Staff managed risks to people’s safety whilst encouraging them to maintain their independence and take part in activities they enjoyed.
The care provided by the Supported Living Service was effective. People’s needs were assessed when they started to use the service. Care records were personalised and identified people’s personal preferences about how they liked their care and support to be delivered. People were supported to access health care and where people had existing health conditions they were supported to manage these. People received care from staff who had received the training they needed to deliver care and that were well supported through supervision and appraisal.
The staff working for the Supported Living Service were caring. We observed positive and respectful interactions between staff and the people they supported. Staff had an excellent understanding of both people’s care and support needs; and their individual preferences. People were listened to and encouraged to express their views about their care and support.
The care provided was responsive to changes to people’s individual needs. If a person’s care needs changed, staff responded promptly to ensure appropriate care and support was provided. People were supported to have choice and control over their lives. Staff had an excellent understanding of how to support people to make decisions. In instances, where staff had determined a person did not have the capacity to make a significant decision, best interests meetings were held to support the person in that decision.
The Supported Living Service was well led. The service had a registered manager in post. There were clear management structures and we found good support and leadership was in place for staff. Records showed that CQC had been notified, as required by law, of all the incidents in the service that could affect the health, safety and welfare of people.
The people who were able to do so told us that their support needs were being met and that they liked the staff members supporting them. One person said; 'very happy, fantastic'. We saw that staff members were interacting well with people in order to ensure that they received the care and support they needed. The relationships we saw were warm, respectful, dignified and with plenty of smiles.
The SLS had a safeguarding policy in place. This included local procedures which staff would follow if they needed to report an alleged incident to the correct authorities.
There were effective recruitment and selection processes in place and people were cared for by staff members who were supported to deliver care and treatment safely and to an appropriate standard.
Information about the safety and quality of service provided was gathered on a continuous and ongoing basis with feedback from the people who used the service.
We made home visits to four people who used the service to gain their views about the quality of the service provided. We looked at care files in people's homes. The people we spoke with said support workers had always treated them with dignity and respect.
Some comments from service users were,' I like all of the staff,' 'I am really happy, everything is fine,' 'I go to the day centre and we go out from there. I like to go shopping with the staff 'and 'We usually go out for lunch on a Sunday.'
We observed some of the support being provided and the interaction between support staff and people using the service. We saw one person, who was a little anxious at first, being reassured by a support worker in a professional, calm and skilful manner.
The following day we met with the registered manager and two senior managers to give some feedback about our findings of the inspection. Overall the service was compliant.