SeeAbility Oxfordshire Support Service

SeeAbility Oxfordshire Support Service is a supported living service providing personal care to six people at the time of the inspection. The service can support up to six people with each person living in their own accommodation.

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.

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.

The service supported people in six bungalows on one site. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a supported living service. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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 positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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

At the September 2018 inspection we found medicines management systems needed to be improved to ensure people safely received their medicines. We found audits and checks did not effectively identify issues or record action taken to make changes and drive improvements. At this inspection we found improvements had been made.

The service had a clear management and staffing structure in place.

The provider had quality assurance systems in place to monitor the quality and safety of the service. These enabled staff and the management team to look at what areas were working well and where improvements needed to be made. There were records kept of accidents and incidents and these were investigated.

People were supported to engage in activities and maintain social relationships with family and advocates. Some people required prompting and motivating to take part in daily life and staff respected people's choices and recognised people’s right to make decisions about their lives.

People were supported to access the health care services they required. Staff had sought guidance and support from different health care professionals to make sure they were providing care which met people's needs. People were encouraged to eat a balanced diet with a choice of meals.

Staff had the right skills, experience and support to meet the needs of people who used the service. Staff worked well as a team and supported people to lead the lives they wanted to.

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.

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 15 October 2018) and there were two breaches of regulation. 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

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

SeeAbility Oxfordshire Support Service offers support for up to six adults in Banbury and up to six adults in Bicester. 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. People had a range of needs, including autism and learning disabilities. The service offered people support twenty-four hours a day to live in their own bungalows which enabled them to have space but to also have people around them as and when they wanted this. At the time of the inspection there were nine people using the service.

The care service has 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 learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

There were some systems in place to ensure people safely received their medicines. However, due to recording errors and a lack of regular medicine audits, we could not be confident that people always received their medicines correctly.

There were various audits and monitoring checks in place. However, some audits had not been recorded and did not always effectively identify where improvements needed to be made.

These were breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment and good governance (Regulation 12 and 17). You can see what action we told the provider to take at the back of the full version of the report.

We received feedback from one person using the service and overall, they spoke positively about the support they received, although said they wished they could make friends with the other people living in the service. We observed that staff treated people with kindness, respect and promoted people's right to privacy.

Relatives told us they were happy with how the move to this new service had been for their family members. The service had made detailed plans for each person and their needs were assessed to ensure the move was at the person’s own pace and accessible communication was used to ensure people could visually see where they were moving to and what to expect. Risks to people's wellbeing had been assessed and planned for along with support plans and guidance on how best to support people.

We received mixed views from the staff team about working at the service. Some told us they were supported and received training, whilst others said the service needed more monitoring, they were not always listened to and people using the service needed more to do with their time.

Social care professionals told us they recognised the service was new and there had been some problems during the first few months with the various changes of staff but that people were settling in and communication was good between the staff team and social care professionals.

There were procedures designed to safeguard people from the risk of abuse and people confirmed they felt safe using the service. 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 supported this practice.

People's health and nutritional needs were assessed and reviewed on an ongoing basis.

There were enough staff on duty to meet people's needs and this was being regularly reviewed. Employment checks were in place to obtain information about new staff before they were allowed to support people. People were supported by staff who were sufficiently trained. Staff were starting to receive more regular one to one support through supervision meetings.

People were provided with information about how to make a complaint and these were managed in accordance with the provider's complaints policy. The registered provider had informed the CQC of all notifiable incidents.