Background to this inspection
Updated
4 November 2022
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 Health and Social Care Act 2008.
Inspection team
The inspection was completed by one inspector.
Service and service type
This service provides care and support to people living in ‘supported living’ settings, 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. However, there was a manager in post who was applying to register with CQC.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out.
Inspection activity started on 3 October 2022 and ended on 10 October 2022. We visited the location’s office/service on 3 October 2022.
What we did before inspection
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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used all this information to plan our inspection.
During the inspection
We communicated with one person who used the service and one relative about their experience of the care provided. We spoke with five members of staff including the home manager, deputy director, team leaders and care workers.
We reviewed a range of records. This included two people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed. We looked at two staff files in relation to recruitment.
Updated
4 November 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Northamptonshire Supported Living Service is a domiciliary care agency. They provide personal care to people living in their own individual flats within a supported living setting. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection four people were receiving personal care.
People’s experience of using this service and what we found
Right support
People were supported by staff who knew them well and focused on people’s strengths and promoted what they could do. Staff supported people to access a range of healthcare services.
Restrictive practice had improved. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff followed best practice and records were clear in identifying the need for any restrictions.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff received training on medicines and any health conditions a person may have.
People were supported with their communication. Staff were trained to understand different communication methods and provided personalised support to people. Information was made accessible in different formats, such as, easy read and pictorial.
Staff supported people to make decisions following best practice in decision-making. The service made reasonable adjustments for people so they could be fully in discussions about how they received support.
Right care
The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff completed nationally recognised training and received regular support from managers to ensure their skills and knowledge was kept up to date.
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. Care plans reflected people needs, wishes and choices.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
Right culture
Oversight of service to assess, monitor and improve the service had improved. However, some systems and processes required embedding into practice. The manager had implemented new systems which were still in their infancy.
People were supported by staff who understood best practice in relation to the wide range of strengths, and needs people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.
People and those important to them, including advocates, were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service.
Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. The manager was supportive to staff and worked directly with people and led by example.
The service ensured people's behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).
The provider, manager and staff were dedicated to achieving best outcomes for people. The provider had a clear vision for the service and promoted improvement and feedback.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 16 March 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.
This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.