The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: West Oxfordshire Supported Living

Overall: Good read more about inspection ratings

Office 1, Mulberry House, 9 Church Green, Witney, OX28 4AZ

Provided and run by:
The Camden Society

All Inspections

3 October 2019

During a routine inspection

About the service

This service is based in Witney, Oxfordshire, and provides personal care and support to people with learning disabilities residing in the North Oxfordshire area. There were 23 people receiving support from the service at the time of the inspection. Supported living is where people live in their own home and receive care and support in order to promote their independence.

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

The culture of the service ensured the provision of support was person-centred. Management and staff were committed to the provision of care and support. People were supported and empowered by staff to control their own lives and live a life which was meaningful to them.

The service applied the principles and values of Registering the Right Support and other best practice guidance. This ensured that people using the service could live as full a life as possible and achieve the best possible outcomes that included 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.

People told us they felt safe, and staff knew whom to contact if they suspected any abuse had taken place. Individualised risk assessments promoted positive supported risk taking. A robust system of learning from incidents kept people safe.

Staff felt very supported with an induction and role specific training, which ensured they had the knowledge and skills to support people. Staff received regular supervision and annual appraisals and were able to reflect on the care and support they delivered.

People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with the utmost respect, dignity, empathy, and compassion. They were empowered to make choices to live a life they wanted. The service had gone to great lengths to ensure people’s preferences and opinions were heard, and the support given was tailored to the individual needs of people.

People continued to be involved in the planning, management and reviewing their support. Each person had a care and support plan, written with them, which reflected their physical, mental health, social and emotional needs. People spent much of their day out in the local community doing the things they wanted and with the people whose company they enjoyed. They were supported to develop and maintain relationships with those who mattered to them. People told us they did not have any complaints but would speak to the registered manager or staff if they were not happy about something.

The provider had systems in place to monitor and improve the quality and safety of the service provided.

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 4 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.

14 February 2017

During a routine inspection

This service is based in Witney, Oxfordshire, and provides personal care and support for people with learning disabilities who live in houses in the North Oxfordshire area. There were 22 people receiving support from the service at the time of the inspection.

At the previous inspection carried out on 21April 2015, the service had been rated as ‘Good’. At this inspection we found the service remained ‘Good’.

People told us they felt safe and staff were aware of their responsibility to ensure people’s safety. Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

Staff knew what action to take if they were concerned that someone was being abused or mistreated. The provider's whistleblowing policy protected staff to make disclosures about poor staff conduct or practice, and staff confirmed the manager would take responsive action if they reported such problems.

Staff had been recruited safely to ensure they were suitable to work with vulnerable people. There were sufficient numbers of skilled staff to meet people's needs and people received their medicines as prescribed.

Records showed staff received the training they needed to keep people safe. The manager had taken action to ensure that training was kept up-to-date and future training was planned.

Staff felt supported by the registered provider. Staff received regular supervision and appraisal to reflect on good practice and areas for improvement.

The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and implemented its principles in their practice. They were knowledgeable about protecting the legal rights of people who did not have the mental capacity to make decisions for themselves. The service acted in accordance with legal requirements to support people who may lack capacity to make their own decisions.

People had access to healthcare when they needed it and recommendations from healthcare professionals were implemented.

Care records showed that people's needs had been assessed before they started using the service and care plans were written in a person-centred way. We saw these care plans were reviewed regularly and with the involvement of people who use the service, their relatives and healthcare professionals. We saw professional advice was incorporated into care planning and delivery.

People described staff as kind and caring. People were supported to maintain friendships with the people they lived with and other people who were important to them. People's independence was supported and their privacy and dignity were respected.

The service had a complaints procedure which was made available to people provided with care and support. People told us they knew how to make a complaint if they had any concerns.

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.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot check and care reviews. We found people were satisfied with the service they received.

23 January and 28 February 2015

During a routine inspection

We inspected West Oxfordshire Supported Living on the 28 January and 23 February 2015. This service works from an office in Witney and provides personal care and support for people with learning disabilities who live in their own homes in the north Oxfordshire area.

The previous inspection of this service was carried out in May 2014. In May the service was found in breach of five regulations in relation to care and welfare, staffing, supporting workers, records, management and quality assurance of the service. We asked the provider to send us an action plan detailing how they planned to make the necessary improvements. This was an unannounced inspection to see whether these improvements had been made, but also to do a full inspection in order to provide the service with an overall rating.

There was a registered manager in post at the service. 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 who used the service were safe as the service had a clear understanding of the risk associated with people’s needs as well as activities people chose to do. The service had sufficient numbers of suitably qualified staff, who had a good understanding of safeguarding and their responsibilities to report suspected abuse. Medicines were administered safely with safe arrangements for storage and recording of medicines.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and had received training in this area. The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. Staff were supported through ongoing meetings and individual one to one supervisions to reflect on their practice and develop their skills. Staff received mandatory training as well as training specific to people’s needs. For example, staff had recived training on Autistic Spectrum Disorder and Epilepsy.

People’s relatives and professionals described the care people recived as outstanding. Staff were caring and showed a genuine warmth and commitment to the people they supported. People felt they mattered to staff and were involved in every aspect of their lives. Staff regularly went above and beyond to ensure people were supported effectively, Where communication could have been a barrier for people the service found ways to ensure the people could communicate in a way that suited them.

People’s needs were assessed and staff understood these needs and responded appropriately when people’s needs changed. People’s interests and preferences were documented and they were encouraged to pursue activities and areas of interest. Social inclusion was an important priority for people and the staff who supported them.

The registered manager had a clear vision for the service that was shared by the staff team. This vision was about complete inclusion and involvement of people and staff in shaping their lives and the service. This vision was being embedded within staff practice and evidenced through people’s care records.

Leadership of the service at all levels was open and transparent and supported a positive culture committed to supporting people with learning disabilities.

7-8 May 2014

During a routine inspection

West Oxfordshire Supported Living is a community service providing care and support to people living in their own homes. It provides services to adults with a learning disability. At the time of our inspection it was providing personal care to 28 people for a varying number of hours each week.

The service had a registered manager in post based in the service’s head office. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. A locally-based “service manager” had been appointed to manage this service on a day to day basis and was in the process of applying to register with the CQC. They told us they also managed other services and spent an average of two days a week at this service.

We found risks were identified, assessed and managed in a way that protected people effectively. The care plans we viewed contained risk assessments together with actions designed to reduce the risks appropriately. However, we found medicines were not managed safely. Medicine audits were not conducted and care plans were not in place to inform staff when ‘as required’ medicines should be given. 

We saw health action plans had been developed so people were able to see doctors or other healthcare professionals when they needed to. One person told us “If I am not well staff help me to sort it out and make an appointment to see someone.” However, the management of people’s epilepsy was not always safe as not all staff were appropriately trained and people who displayed behaviour that challenged others did not always receive appropriate care and support. There was no care plan in place to manage one person’s behaviour.

Staff did not always receive supervision and appraisal so were not appropriately supported to provide care safely and to a suitable standard. Some staff had not been trained in epilepsy or the Mental Capacity Act, 2005 (MCA), although they were providing care and support to people who suffered from epilepsy and had varying levels of mental capacity. This meant staff may not have been able to provide safe care when people had a seizure and may not have been able to support them appropriately to make decisions.

However, we saw training in the Mental Capacity Act, 2005 (MCA) was planned to be delivered to all staff in the near future. The manager also told us of plans to develop new ‘essential life plans’ for people, which would include assessments of their mental capacity to make specific decisions. This would provide staff with the necessary knowledge and information to enable them to protect people’s rights appropriately.

We identified that some care plans were not up to date and did not reflect people’s current needs. We saw decisions had been made about people’s ability to manage their own medicines. However, it was not clear how those decisions had been made or whether the process used had complied with the principles of the MCA and its code of practice.

We observed the support coordinators trying and find staff to cover shifts to provide all the necessary support that was required. They told us this was a constant challenge due to staff shortages.

People told us they were not always aware of which staff were supporting them on a daily basis. One person said, “I don’t get a rota and I don’t know what day or what times or who is coming. My days and times change every week and I don’t like all the swapping around.” Whilst staff were deployed in a way which ensured people received their allocated number of support hours, staff shortages meant people did not always experience care and support from a staff team that was consistent.

We found the quality assurance system was not operating effectively. Support coordinators were required to conduct checks of each house to assess and monitor the quality of care provided by staff. They told us theses were not being conducted because they did not have time to do them. One said, “Our backs are against the wall just trying to cover basic shifts.” This meant the service was unable to demonstrate they were providing safe quality care.

People we spoke with told us they felt safe being cared for by the staff. They said they were confident they could raise any concerns with members of staff and that these would be dealt with. People told us they received the care and support they needed and were happy with the service. One person said, “Living independently for the first time in my life has been a big success.”

People were treated with dignity and respect and were listened to. One person said, “The staff always treat me with respect and speak to me nicely.” We observed staff spoke to people respectfully and in a friendly way; they adapted their vocabulary appropriately, took time to listen and called people by their preferred names.

Each person had a key worker who knew them well and whom they had developed positive relationships with. People told us they felt staff listened to them and we saw time was set aside each week for people to meet their key workers to discuss their care and wishes. One person told us “I feel staff listen to me and we have lots of meetings to talk about the things I want.”

Staff told us there was an open culture in the service. An experienced member of staff said, “The Camden Society are doing a good job, there isn’t a big hierarchy so communications are more direct.” We found the manager was open and accepting of the identified improvements that were required at the service and had clear ideas about how they could be achieved.

The concerns identified meant there had been breaches of the relevant regulations (Regulations 9, 10, 13, 20 and 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010). You can see the action we have told the provider to take at the end of this report.

13 November 2013

During a routine inspection

26 people were receiving a service from the provider. We spoke with six people and five care workers.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. However, the provider may wish to note staff had not documented where people had consented for them to share information on their behalf.

People told us they were happy at the service, one person signalled their happiness by smiling and laughing. Another person said "I am treated very well the staff are really good".

We saw that people's support involved other providers. We noted that one person received support from a local day centre. We saw that the provider's contacted each other regarding the person's health concern. This meant that people had choice and were protected because information on their day to day needs was shared.

Evidence of employee's previous conduct was obtained. References were taken up before the person started work. One of these references was always from the care workers most recent employer. In addition each person was checked against the disclosure and barring (DBS) list prior to being offered employment.

People we spoke with told us they felt able to raise concerns and the provider responded to complaints and compliments. People and their relative's views on the service had been sought.

The provider took appropriate action regarding medication administration errors.

30 January 2013

During a routine inspection

People who used the service told us that they were happy with the support they received and evidence indicated that they were consulted and involved in how they wished to live their lives.

We found that peoples health and welfare needs were being met and that support given was individualised and person centred.

Evidence informed us that systems were in place to protect people from possible abuse and that staff had an awareness of safeguarding issues. People told us they were well treated.

We found that staff had undertaken appropriate training and received regular support, supervision and appraisal.

We found that the quality of the service was being monitored and evidence indicated that concerns were promptly acted upon.