Background to this inspection
Updated
23 September 2021
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors and an Expert by Experience carried out this inspection. 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 a ‘supported living’ setting, 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 a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service and two relatives about their experience of the care provided. We spoke with three members of staff including the registered manager, deputy manager and senior support worker.
We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff and the person themselves. In this report, we used this communication tool with one person to tell us their experience.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies, procedures and quality assurance records. We spoke with one professional who was regularly in contact with the service.
Updated
23 September 2021
About the service
Care TaylorMade Ltd is a supported living service providing personal care to adults with learning disabilities, autism and physical and mental health needs. There were three people using the service at the time of the inspection. People had their own rooms in a shared house, which had a number of communal areas and a garden. The accommodation had a room for staff to use so the service could provide 24-hour support.
People’s experience of using this service and what we found
The service was exceptionally caring. People were treated with respect and compassion at all times. The service excelled at supporting and empowering people to express their views. People were involved and supported to make decisions about their own care. The service had embedded a culture of respecting people’s rights, privacy, dignity and choice. Staff were pro-active, sensitive and aware of people’s individual needs.
People received exceptionally person-centred care. The service had worked hard to encourage and support people’s independence. People were now administering their own medicines, ordering their own food and drink in cafés and pubs, and handling small amounts of money. The service used creative, innovative and personalised methods to help people reach their goals and improve their quality of life. People were encouraged to take part in activities which were important to them. One relative told us, “We have seen positive changes in [person] since they have been there. [Person] is more organised, tidier and [person] plans themselves what they want to do. [Person] seems happy and contented.” The service had a culture of open and honest discussions and carried out especially detailed investigations into any concerns raised.
The service was consistently well-led. There were high levels of satisfaction throughout the service. There were clear roles and responsibilities within the service and the registered manager understood their regulatory and legal requirements. Comprehensive audits were undertaken, and quality improvement was promoted. People, relatives and staff were encouraged to give feedback and the service was extremely pro-active in engaging with other professionals to achieve good outcomes for people.
People were supported to be safe. Staff understood their safeguarding responsibilities and built positive and trusting relationships with people. Risks to people were effectively assessed and safely managed. Staff were recruited safely and there were enough staff to meet people’s needs. People received their medicines as prescribed and the service safely managed infection control.
People’s needs were comprehensively assessed and reviewed. Care files were meaningful for each individual person. Staff had the right skills, knowledge and experience to support people effectively, and people were involved in the recruitment process. People were supported to maintain a balanced diet and prepare meals where possible. People’s health needs were met in an effective and timely manner.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were given choice and supported to make decisions about their own care. People were supported to be as independent as possible. People were encouraged to pursue their individual likes and interests. People were treated with dignity and respect at all times. The service had an exceptionally person-centred culture and welcomed feedback.
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 23 November 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
We looked at infection prevention and control measures under the safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.