Background to this inspection
Updated
10 January 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 Care Act 2014.
Inspection team
This inspection was carried out by a single inspector.
Service and service type
This service provides care and support to people living in their own homes or ‘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.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 28 November 2022 and ended on 16 December 2022. We visited the office location on 8 December 2022.
What we did before inspection
We reviewed information we had received about the service since the last 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.
During the inspection
We spoke with the registered manager and head of human resources at the service. We reviewed records and sought verification of both permanent and temporary agency staff background checks.
Updated
10 January 2023
Centre 404 provides personal care services to adults with a learning disability living in their own homes in the London Borough of Islington. There were 48 people using the service at the time of this inspection on 30 October and 2 and 6 November 2017.
This inspection was short notice, which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 4 and 18 August 2015 the provider met all of the legal requirements we looked at and was rated Good.
At this inspection we found the service remained Good.
The service had a registered manager in place. 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 and associated Regulations about how the service is run.
Staff respected people’s privacy and dignity and worked in ways that demonstrated there was diligence at ensuring this. People’s preferences were known about and were recorded and staff worked well to ensure these preferences were respected. The provider and staff teams worked hard to ensure that the service offered an outstandingly caring environment. The service was bespoke and built around the people that used it and was not operated for anyone’s convenience other than the people that used the service. Compassion and respect were at the heart of the values that staff displayed and people’s abilities, or impairment to their abilities, did not dictate how they were supported to live their lives.
People using the service, relatives and other stakeholders were highly satisfied with the way the service worked with people and the steps that were taken to keep people safe from potential avoidable harm.
The service was diligent with ensuring that the requirements of the Mental Capacity Act (2005) were complied with. Where Deprivation of Liberty issues were applicable, this too was managed well and proper consultation took place to help protect people’s human rights.
People who used the service had a variety of support needs, in some cases highly complex needs, and support plans clearly described people’s care and support needs and provided clear guidance for staff about how to meet these needs. Any risks associated with people’s care were assessed, and the action needed to minimise risks was recorded. Risk assessments were updated regularly and did not place restrictive limitations on the reasonable risks that people were allowed to take.
Staff training described mandatory training required for all staff as well as specific training required where staff worked with people that had specific care needs that required staff to undergo specialised training. Staff participated in regular supervision which was designed as a supportive process for staff as well as to address their development and work with the service. Staff appraisals took place yearly and development and training objectives were set arising from the appraisal system.
People were informed about how to complain and were supported to raise concerns if they were unable to do it independently by using advocacy services if a family member or friend could not assist with this on their behalf. If concerns were raised these were listened to and the provider was open about action taken and changes made as a result.
People who used the service, relatives and stakeholders had a range of opportunities to provide their views about the quality of the service. The provider worked hard to ensure that people were included in decisions about their care and their views about how the service was run were respected and taken seriously.
At this inspection we found that the service met all of the key lines of enquiry that we looked at and was not in breach of any of the regulations.
Further information is in the detailed findings below.