Gateshead Supported Living Service 1, 2 and 3

About the service

Gateshead Supported Living 1 and 2 is a ‘supported living’ service providing personal care to people with a learning disability and/or autism living in 8 homes. The service was supporting 33 people with personal care at the time of our inspection.

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

Right Support

¿ People were comfortable in their own homes and able to do what they wanted to do, when they wanted. They were encouraged to get back to the hobbies and interests they had enjoyed pre-pandemic. Staff helped people enjoy a good quality of life through helping them access a range of healthcare professionals.

¿ Staff advocated for people and ensured changing needs were flagged with internal and external specialists.

¿ People experienced good health and wellbeing outcomes. Leaders were aware of the principles of Stopping the Over-Medication of People living with Autism and/or a Learning Disability (STOMP) and other good practice.

Right Care

¿ Staff cared about people receiving high quality care. They had received mandatory training, although some was in need of refreshing in line with the provider’s policies. They helped people live the life they wanted. Staff understood people’s differing needs and independence.

¿ People got on well with each other, and staff. People had strong bonds with people they lived with and were more confident in accessing the community since the pandemic.

¿ Staff communicated well with people.

¿ Support plans and risk assessments needed some work to ensure they remained accessible, person centred and focussed on the things people wanted to achieve. We have made a recommendation about this.

¿ Staff worked well with external professionals to keep people safe. They followed advice and were proactive in raising concerns or changes.

Right culture

¿ The culture of the service was changing, with new registered managers planned and some experienced staff moving roles. The area manager acknowledged some difficulties in recruiting and retraining staff to ensure that people received a continuity of care. Staff knew their roles well but documentation was not always up to date.

¿ People and those who knew them best were involved in decisions about their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This inspection took place on 4 October 2017 and was announced. We spoke with people, relatives and staff in the following days and concluded the inspection on 9 October 2017. We previously inspected this service in March 2015 and overall we rated the service as good. At that time, we identified the service required improvement to be completely effective and recommended that the provider reviewed the guidance for consent to care and treatment in the Mental Capacity Act (MCA) 2005. At this inspection we found the service remained ‘Good’ and met all of the fundamental standards we inspected against.

Two established registered managers were in post and this has not changed since our last inspection. 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.

We found staff understood the principals of the MCA and their responsibilities when they assessed people’s capacity. Decisions that were made in people’s best interests had been appropriately taken with other professionals and relatives involved. Detailed care records were maintained which described why an assessment had been carried out and what action had been agreed.

People spoke very highly of the staff who supported them to live at home. They told us they felt safe and comfortable with the support workers and they received a good service. Policies and procedures were in place to safeguard people from harm and the staff we spoke with understood their responsibilities. Records were kept about concerns of a safeguarding nature and timely investigations had taken place.

Detailed risk assessments were in place to protect people from any risks they may encounter in their daily lives. Accidents and incidents were appropriately reported to the office staff and these had been recorded and monitored.

Recruitment checks continued to be carried out to ensure that staff were suitable to work with vulnerable people and there were sufficient numbers of staff deployed to meet people’s needs. A robust induction process was in place and staff training was up to date. Records confirmed that suitable training was available to ensure staff were knowledgeable and skilled.

Staff confirmed they received regular supervision and appraisal and team meetings were held within each household. Staff felt there were enough of them employed to manage each household with consistent support workers.

People's nutritional needs were met and they were supported to access healthcare services as required. Medicines were managed safely and in line with best practice.

Care records showed people were involved in their care and support. People were supported to have choice and control of their lives and staff supported them to be as independent as possible. Staff sought people’s consent before carrying out any care or support.

We observed a lot of positive interactions between staff and people who lived at the services where privacy and dignity was promoted and protected. The staff we spoke with displayed caring attitudes. All of the people we spoke with said they were treated with dignity and respect and that staff were nice and friendly towards them and their families. The relatives we spoke with confirmed this.

Comprehensive person-centred care plans were in place to support staff to provide an exceptionally personalised service. Records demonstrated that regular reviews were carried out of the support people received. Staff supported people to enjoy a range of meaningful activities and to pursue education and work. Without exception staff strived to ensure people lived their lives to the fullest and achieved their maximum potential. We found this had an extremely positive impact on people's health, well-being and quality of life.

No complaints had been received by the service since our last inspection. The provider actively encouraged people to share their opinion of the service. Lots of positive feedback had been received and this was shared with the staff.

The registered managers proactively monitored the quality of the services; they maintained manual and electronic records which related to all aspects of the service such as safeguarding, complaints, accidents and incidents. The registered managers and deputy managers carried out spot checks on support workers and they regularly spoke with people and their relatives to gather feedback. Action plans were developed to address any areas which required improvement.

Staff spoke highly of the registered managers. They told us they felt valued and enjoyed their work.

Family members told us they were happy with the care their relatives received. One family member said they were, 'Thrilled with the service, the staff are very friendly and helpful. X has settled very well.'

We found there was a consistent staff team who knew and understood people's needs. We found the staff team has had a number of vacancies since the service transferred to a new provider and staff were working additional hours to cover the shortfall. Family members commented, 'The staff are most helpful and most co-operative'; 'They (staff) have all pulled exceptionally well as a team. We have spoken to them regularly. They are a much improved and cohesive team. They have improved in every way', and, 'The service is more friendly and professional now. The staff are more informative and seem to have a better, closer relationship. X is still really happy living there.'

We found that some key records, particularly care plans, had not been updated or reviewed since the service transferred.