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Inspection carried out on 23 September 2019

During a routine inspection

About the service

Shy Lowen Care Limited is a supported living service. They provide personal care and support to people with learning disabilities and/or autism who live in their own home in order to promote their independence. The support that people receive is often continuous and tailored to their individual needs. Two people living in one separate supported living setting received the regulated activity of ‘personal care’ from Shy Lowen Care at the time of the inspection.

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.

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

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, where staff had assessed people’s capacity and decisions had been made in their best interests, these had not always been documented. We have made a recommendation regarding this.

People and their relatives were positive about the caring nature and approach of staff. Relatives told us their family members were supported by staff who were kind and compassionate. They told us people were safe with the staff who supported them and were confident that any concerns would be dealt with promptly. Appropriate numbers of staff supported people to deliver the care and support people required.

Staff told us they had received appropriate training which supported them to carry out their role. Staff told us they could seek advice from the registered manager. The registered manager and staff were passionate about the care they delivered and were driven to improve the service. They communicated and engaged with others, such as family members. to improve the lives for people. Quality assurance systems had been introduced to identify and address shortfalls in the service.

The registered manager acted on concerns to ensure people received care which was safe and responsive to their needs. Staff were trained in safeguarding people and protecting them from harm. Any concerns or accidents were reported and acted on. The risk posed to people had been assessed and suitable action had been taken to minimise the risk posed to people using the service.

The registered manager monitored the delivery of care through staff observations and feedback from people.

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

The last rating for this service was Good (published 15 July 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.

Inspection carried out on 1 March 2017

During a routine inspection

Shy Lowen provides personal care for people with a learning disability living in their own home. Accommodation is leased from a private landlord. Up to five people will eventually live together. At the time of our inspection two people were receiving personal care from Shy Lowen. Their care and support was provided by one member of staff which meant they shared their care and support.

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 and associated Regulations about how the service is run.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People received a highly individualised service from Shy Lowen which reflected their individual needs and lifestyle preferences. Care records highlighted how they wished to be supported, what they could do for themselves and routines really important to them. People were supported by staff who knew them really well and who treated them with dignity and respect. People said they felt safe with the staff, in their home and in their community. Any risks were reduced to keep them safe from harm.

People’s rights were upheld. They were supported to maintain relationships with people important to them. They had the opportunity to participate in activities which reflected their age, disability and lifestyle. Accessible information had been produced using pictures and symbols to illustrate the written word so they could understand documents and records. Their personal information was kept securely and confidentially.

People benefited from staff who were supported in their roles and able to complete training relevant to people’s needs. Staff found the registered manager open and accessible. They said they could call on the registered manager for help and support at any time. The registered manager worked closely with them and was able to observe staff working with people.

The registered manager said, “Caring is our top priority.” Quality assurance processes monitored the standards of care provided and included feedback from people using the service and relatives. They said, “I am happy living here” and “We are both extremely happy with [name’s] care, [name] is very happy.” Staff reflected, “We make sure they have what they need to live normal lives and have access to what they want.”

The service met all relevant fundamental standards. Further information is in the detailed findings below.

Inspection carried out on 8 June 2015

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection of this service on 29 January 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to breaches of Regulation 20 HSCA 2008 (Regulated Activities) Regulations 2010, Records (which corresponds to Regulation 17(2)(d) HSCA 2008 (Regulated Activities) Regulations 2014 Good Governance). There was also a breach of Regulation 21 HSCA 2008 (Regulated Activities) Regulations 2010 Requirements relating to workers (which corresponds to Regulation 19 HSCA 2008 (Regulated Activities) Regulations 2014 Fit and proper persons employed).

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shy Lowen Care Limited on our website at www.cqc.org.uk

People received care which reflected their individual needs, aspirations and wishes. Their care records clearly summarised the support they received and reflected any changes in their needs. Any risks were minimised and risk assessments indicated how hazards were managed to keep people safe. People’s records had been discussed with them and were produced in formats appropriate to their needs using plain English and pictures. Quality assurance processes monitored and audited care records to make sure they were up to date.

People were protected from the risks of inappropriate care because staff recruitment now made sure all checks and records required by the Care Quality Commission were in place for existing staff and would be obtained for any new staff.

Inspection carried out on 29 January 2015

During a routine inspection

This inspection was announced and took place over two days on the 29 and 31 January 2015. Shy Lowen opened in October 2013 and this is the first inspection of the service. Shy Lowen did not start providing a service to people until September 2014. Shy Lowen provides personal care for people with a learning disability living in their own home. Accommodation is leased from a private landlord. Up to five people will eventually live together. At the time of our inspection one person was receiving personal care.

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 and associated Regulations about how the service is run.

People were not protected from the risk of harm. Although strategies were in place to minimise hazards and staff were carrying these out, risk assessments had not been put in place to formally describe the methods used. We also found the provider had not developed care plans from people’s initial assessment of need and care plans provided by their placing authority. Staff were however delivering care which focused on the individual needs of the person. The lack of accurate records in respect of the person’s care and support could potentially put them at risk of unsafe or inappropriate care being delivered. This was a breach of our regulations.

We found another breach of our regulations. Recruitment and selection procedures were not effective. Some information required prior to new staff starting their employment had not been obtained. The character and fitness of staff to support people had not been verified which could put people at risk of harm. You can see what action we told the provider to take at the back of the full version of the report.

Quality assurance processes were developing which including providing the opportunity for people, staff and relatives to express their views and opinions about how the service could improve. Audits mostly monitored the quality of service provided and the challenges facing the development of the service.

The person using the service told us, “This is my house, carers help me clean it. I choose when to get up and when to go to bed. They (staff) look after me, help me with my shower and help me when I want.” They were treated with respect by staff and enjoyed being in their company. When they needed to be alone they listened to music or chose to go to their room. They were supported to be independent and develop new skills such as shopping and cooking. Activities were supported in the local community reflecting individual interests and hobbies.

Staff were supported through individual meetings with the manager and team meetings to discuss their roles and responsibilities. Training was provided which was relevant to people’s needs such as learning disability or autism awareness. There were enough staff employed and strategies were in place to cover in an emergency.

People’s safety was promoted through providing a safe environment and safe work practices. Staff had completed safeguarding training and systems were in place to record and report suspected abuse. There had been no accidents or incidents. People were supported to stay well using local health care services.

Information was produced in formats appropriate to people’s needs using plain English, pictures and symbols. The registered manager had guided people through tenancy agreements and policies and procedures such as staying safe and making a complaint. A relative said they were kept informed and involved and told us the registered manager would deal with any concerns they might have.