Background to this inspection
Updated
8 August 2023
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
This inspection was carried out by 2 inspectors.
Service and service type
This service provides care and support to people living in 1 ‘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 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 a registered manager in post.
Notice of inspection
We gave the service 48 hours’ 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.
The inspection started on 5 July 2023 and finished on 6 July 2023. We visited the head office and supported living service on 6 July 2023.
What we did before the inspection
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 reviewed the information we held about this service. This included statutory notifications in relation to accidents, incidents or any safeguarding concerns.
During the inspection
We spoke with 5 staff which included the registered manager, the provider’s director of care services and 3 care staff. We spoke with 1 person who used the service as some people were out or were unable to communicate with us verbally.
We reviewed the care plans for 4 people in varying detail, looked at medicine records and 3 staff recruitment files. We looked at information in relation to the running of the service such as audits, training details, surveys and staff meeting minutes.
On the day before our site visit, we spoke with 3 relatives to obtain their feedback about the care their family member received.
Updated
8 August 2023
About the service
Millsted Support is a service which provides personal care to people living in a supported living setting. The service provides care to people with a learning disability or autistic people. At the time of our inspection, 4 people (all male) were receiving care from the service. Everyone lived together in one home.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support:
People’s independence was promoted and people were able make decision about how they wished to receive their care.
People were being given the opportunity go out and to participate in activities of their choice.
People were respected by staff who engaged with them well and helped to ensure their privacy was upheld.
Staff followed safe systems in relation to a person’ medicines. They also followed infection control processes such as using gloves and masks when needed.
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.
Right Care:
People received care in a kind and respectful way by staff who knew people. Staff knew, how to communicate with people and how they liked their care to be provided.
People were supported to make their own decision around the care they received as well as the food they ate. Where people could prepare their own meals, they were supported to do so.
People were protected from possible abuse. People said they felt safe with staff and staff were trained in how to recognise abuse. Staff also knew of risks related to people and followed guidance to help people remain safe.
People were cared for by a sufficient number of staff who had received training in their role and were supported by management.
Right Culture:
Improvements had been made since our last inspection. People, relatives and staff all felt a positive shift in the service. They described the service as one that focused on a person as an individual and gave people the opportunity to decide how they wished to spend their time.
People, staff and relatives were involved in the running of the service. Management was approachable and willing to listen. Staff worked with external agencies to provide effective and appropriate care to people.
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 March 2022).
We found the provider was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as there was a lack of management oversight and governance arrangements in place. We also found the provider was in breach of Regulation 18 Registration Regulations 2009, as they had not submitted notifications of accidents or safeguarding concerns to CQC which is a requirement of registration.
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 these regulations.
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.