Background to this inspection
Updated
25 October 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 carried out by one inspector.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 13 September 2022 and ended on 14 September 2022. We visited the location’s office on 13 September 2022.
What we did before the inspection
We reviewed information we had received about the service since they were registered with us. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager. We reviewed a range of records. This included three staff files in relation to recruitment and supervision. We looked at audits and meeting minutes. We looked at both people’s care records. A variety of records relating to the management of the service, including policies and procedures were reviewed. After we visited the office, we looked at training data, medicines records and quality assurance records and spoke with one of the supported living manager. We also contacted, staff and external professionals to ask for their feedback about the service and spoke with a relative.
Updated
25 October 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
Supported Living Services Uxbridge provides one supported living service for up to four people with learning disabilities and autism living in shared accommodation within a supported living scheme in Derbyshire. The aim is for people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. At the time of our inspection there were two people using the service.
People’s experience of using this service and what we found
Right support:
People did not always receive the right support. Staff did not always follow the procedure for the safe administration and recording of medicines. We found a number of discrepancies in people’s medicines administration records. (MARs). There were systems in place to monitor the management of medicines but these had not identified shortfalls.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
Risks to people’s safety and wellbeing were appropriately assessed and mitigated. There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements.
People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People's needs were assessed before they started using the service and care plans were developed from initial assessments. People and those important to them were involved in reviewing care plans.
Right care:
People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. The staff supported people in a person-centred way and respected their privacy, dignity and human rights.
Records indicated people’s needs were met in a personalised way and they had been involved in planning and reviewing their care. The registered manager told us the staff were kind, caring and respectful and had developed good relationships with people who used the service.
The provider worked closely with other professionals to make sure people had access to health care services. People’s nutritional needs were assessed and met.
We were unable to speak with people who used the service but spoke to one relative who had mixed views about the service. They had not been involved in care planning and had not seen their family member’s care plan.
Right culture:
Staff were responsive to people’s individual needs and knew them well. They supported each person by spending time with them and listening to them. They ensured that each person felt included and valued as an individual. People were engaged in meaningful activities of their choice. They were consulted about what they wanted to do and were listened to.
Staff told us they were happy and felt well supported. They enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 11 June 2021 and this is the first inspection.
The service was inspected based on the date they were registered with us.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified a breach in relation to safe care and treatment and have made a recommendation in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.