Background to this inspection
Updated
31 August 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 Care Act 2014.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
Inshore Support Ltd provides care and support to people living in their own homes, known as 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.
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
We gave the service 48 hours' notice of the inspection visit because it is small, and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who regularly visit the service. The provider had completed a provider information return on 21 January 2022. 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. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with one people who used the service and five relatives about their experience of the care provided. Due to the high needs of people who used the service, we were unable to speak to more than one person. We also reviewed complaints, compliments and surveys, which gave us further insight into the quality of people's care and what it was like to live or work at Inshore Support Ltd. We also spoke with five members of staff including the director of care, the registered manager, and three care workers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. The registered manager sent us additional information including policies, governance meeting notes, health and safety audits as well as general audits. We spoke with one healthcare professional who regularly visits the service and one person’s social worker.
Updated
31 August 2022
About the service
Inshore Support Ltd is a supported living service providing personal care for up to 23 people with a learning disability or autistic spectrum disorder. At the time of inspection 23 people were living across multiple properties within the region. All people receive a minimum of one-to-one support throughout the day and night.
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.
The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.
Right support
People were supported to have choice, staff supported people in the least restrictive way possible.
The provider supported people to make choices, and have control over their own lives, such as what time they got up and went to bed.
Right care
We saw that staff were caring and promoted the people they were supporting dignity.
Right culture
Staff had training on how to recognise and report abuse and they knew how to apply it. Staff told us how they would recognise pain, distress and discomfort in people who could not verbally communicate.
People felt safe and staff had good knowledge of safeguarding processes.
Staff had been recruited safely.
There was a system in place to monitor staff contact with people in the form of daily logs to ensure continuity of care after shift changes. Care plans and risk assessments identified people’s support needs and staff had a good understanding of the support people needed.
Infection Controls were in accordance with good hygiene practices.
Leadership decisions about encouraging independence meant that people were encouraged to do as much as possible for themselves to promote independence.
People were treated with kindness and compassion. People felt well supported. People’s privacy and dignity was maintained.
People received person centred care. People, relatives and staff expressed confidence in the registered manager. People, relatives and staff were given the opportunity to provide feedback. Audits took place to ensure the quality of the service was maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 17 December 2010. It was last Inspected on 08 June 2019 with an overall rating of ‘Requires Improvement’. A warning notice was issued due to the provider not having sufficient systems in place to monitor and improve the quality of the service. We found that this had improved at this inspection and the provider is no longer in breach of Regulation 17; Good Governance.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. We inspected to follow up on the previous breach of regulation 17, as well as to investigate some concerns around whistleblowing reports we had received, and only looked at the Safe, Effective and Well-led key questions.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has improved to Good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inshore Support Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.