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Inspection Summary


Overall summary & rating

Inadequate

Updated 13 February 2020

About the service

Stepping Out provides short to medium term residential accommodation for up to seven adults with enduring mental health conditions, who would benefit from a short to medium stay in a residential setting. At the time of this inspection there were five people living in the service.

Stepping Out is a two storey house with five bedrooms on the first floor and two bedrooms on the ground floor. There are communal areas such as a kitchen and two lounge areas, together with outside space and a garden.

Stepping Out is a service that aims to support people to make changes in their lives to become more able to cope with day to day living. The aim is to empower people to reach their goals and develop coping strategies in preparation for independent living.

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

People and staff were at risk of avoidable harm; plans to manage known risks to people were unclear and did not provide staff with enough information to keep people safe. There was little evidence of learning from events or action taken to improve safety.

Staffing levels in the service were not adequate to ensure people and staff were safe at all times. Staff told us they did not always feel safe with the number of staff on shift.

People’s medicines were managed safely, and staff kept accurate records

Staff received relevant training, but this needed to be extended to include more in-depth training due to the increasing complexity of people’s needs.

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.

Support plans failed to take into account a full assessment of people's needs. One support plan was blank, despite the person having lived in the service for over three months. Old information was also contained within some support plans. Therefore, staff were not always able to support people in the most effective way as some information was not made available to them.

The provision of meaningful activity did not always meet people's individual needs. Some people told us that they would enjoy group activity, but due to staffing levels this had not always been possible. We have made a recommendation about this.

Governance systems in place were not sufficiently robust to enable the service to identify where safety and quality was being compromised, and to drive continual improvement. Accidents and incidents were not analysed in order to identify trends or patterns and therefore mitigate future risk.

Despite significant shortfalls in the safety and governance of the service, people praised the kind and caring nature of staff. We observed positive interactions between staff and people throughout the inspection. People repeatedly gave us positive examples of how staff had changed their lives for the better and helped them reach their goals.

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 31 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive, and well-led sections of this full report.

The provider took some immediate actions during and following the inspection, such as increasing staffing levels and arranged for a health and safety review of the premises.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to safe care and treatment, staffing, person-centred care, governance, and reporting pr

Inspection areas

Safe

Inadequate

Updated 13 February 2020

The service was not safe

Details are in our safe findings below

Effective

Requires improvement

Updated 13 February 2020

The service was not always effective

Details are in our effective findings

Caring

Requires improvement

Updated 13 February 2020

The service was not always caring

Details are in our caring findings

Responsive

Requires improvement

Updated 13 February 2020

The service was not always responsive

Details are in our responsive findings

Well-led

Inadequate

Updated 13 February 2020

The service was not well-led

Details are in our well-led findings below