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Inshore Support LTD - Supported Living Requires improvement

Reports


Inspection carried out on 3 April 2019

During a routine inspection

The overall rating for this service is requires improvement

About the service:

Inshore Support LTD - Supported Living is a supported living service providing personal care to 21 people with learning disabilities, and physical disabilities. All people receive a minimum of one-to-one support throughout the day and night

People’s experience of using this service:

There was a high use of agency staff and staff turnover meaning consistent care and support was not always delivered. Relatives, staff and professionals told us that there was a lack of activities and this effected people's quality of life and behaviours.

Quality assurance processes were not effective and did not pick up all the issues we identified. This included care plans and risk assessment not being accurate and up to date.

Systems and processes were not being used effectively to ensure people received good quality care. We saw monitoring charts that were not effective in relation to fluids and medicines.

The provider had not assessed people’s capacity in relation to day to day decisions and there were restrictions written into people’s care plans with no supporting evidence. It was not evident whether people had agreed or consented to some areas of their care and treatment or had contributed to the development of their care plans.

People were supported to access health care services when they needed, and we saw referrals had been made to the local community teams.

Relatives said they could talk to staff. People and relatives were confident if they raised a complaint, it would be dealt with appropriately.

Rating at last inspection

At the last inspection the service was rated good (report published 04 June 2016). The overall rating of this service has dropped since the last inspection.

Why we inspected

This was a planned inspection based on the ratings at the last inspection. The inspection took place on 03 and 04 April 2019

Enforcement

Full information about The Care Quality Commission’s (CQC) regulatory response to more serious concerns found in inspections and appeals is added to reports after any representation and appeals have been concluded.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 6 April 2016

During a routine inspection

This inspection took place on 6 and 8 April 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because we wanted to make sure staff would be available to answer any questions we had or provide information that we needed. We also wanted the registered manager to ask people who used the service if we could visit them in their homes or at a place of their choosing. At our last inspection on 17 December 2013 the service was meeting all of the regulations that we assessed.

The service is registered to provide personal care and support to people in their own homes. At the time of the inspection the service was providing support and personal care to 21 people who were living in their own homes within eight ‘supported living’ facilities within the community. Supported living enables people who need personal or social support to live in their own home supported by care staff instead of living in a care home or with family. The levels of support people received from the service varied, according to their assessed needs and levels of independence.

A registered manager was employed at the service. 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 2008 and associated Regulations about how the service is run. The registered manager was on leave on the day of the inspection and we therefore spoke with the quality manager who was acting on their behalf.

People felt safe and were supported by staff who had received training in how to recognise possible signs of abuse and how to report any concerns. Staff spoken with were aware of their responsibilities in this area and what actions they should take. They were aware of the risks to people on a daily basis and how to manage those risks.

Staff were recruited safely and appropriately. Staff received an induction and opportunities to shadow colleagues prior to commencing in post.

People were supported by staff who received regular training to ensure they had the skills to meet the needs of the people they supported. Systems were in place to ensure that all training was up to date and staff had the opportunity to attend additional training in specialist areas in order to develop their skills.

People were supported to live their lives in the least restrictive way possible. Staff understood the requirements of the Mental Capacity Act [MCA] and Deprivation of Liberty Safeguards [DoLS], and what it meant for the people they supported.

People were supported with their nutrition and health care needs.

People were supported by staff who were kind and caring and helped them maintain their independence.

People were involved in developing how they wanted to be supported. Information was made available to people in an easy read format to enable them to participate in their care planning.

People’s care needs were regularly reviewed and staff kept up to date with any changes in their care or support.

People were confident that if they had any concerns, they would be dealt with appropriately.

The management and staff group were described as supportive and approachable. Staff felt listened to and were able to contribute to the running of the service.

A number of audits were in place to assess the quality of the service provided. Efforts were regularly made to obtain feedback from people who used the service, in order to improve the quality of care provided.

Inspection carried out on 19 December 2013

During a routine inspection

As part of our inspection we spoke with two people who used the service, two relatives, six members of staff and the registered manager. In this report the name of the registered manager, Miss Tracey Lake was not in post and not managing the regulatory activities at this location at the time of our inspection. Their name appears because they were still identified as the registered manager on our register at the time.

We saw that care plans were person centred and comprehensive. People’s needs had been individually assessed. Care plans contained a good level of information about how people should be supported to ensure their needs were met. One relative told us, “We are very happy with the care X receives”.

People and relatives we spoke with said they felt safe and able to speak with staff if they were unhappy or worried. We found that people who used the service were protected from the risk of abuse.

Staff were well trained and knowledgeable about people’s care needs. Staff we spoke with told us they enjoyed their jobs and they felt supported by their manager. One staff member told us, “They are pretty good about making sure we get supervision.”

There were quality monitoring programmes in place, which included people and relatives giving feedback about the care and support being provided. This provided an overview of the quality of the service and areas needing improvement.

We looked at records and these were easily accessible, securely stored and fit for purpose.

Inspection carried out on 20 December 2012

During a routine inspection

We spoke with two people and three members of staff.Three relatives were spoken to by phone the following day.

People told us that they were happy with the service and it made a difference to people's lives. They told us that care workers completed the care and support they required, treating them with respect and dignity.

People had the same carers whenever possible which allowed for continuity. People felt they were supported in a way that promoted their independence whilst maintaining their safety. A relative said, “He is supported to enable him to do things for himself”.

Systems were in place to protect vulnerable people. Staff told us they had undertaken training about safeguarding issues and training records confirmed this. Staff had a good understanding of what may constitute adult abuse and knew the procedures should they become aware of abuse. We saw that safeguarding concerns had all been properly notified to the relevant agencies and investigated to ensure people were safe from harm.

Staff we spoke to told us that the agency supported them with the necessary levels of training to do their jobs well. Effective checks had been carried out into new staff’s background prior to their employment commencing to ensure they were suitable to work with vulnerable people.

People we spoke with were confident that they could raise concerns about the quality of the service. A relative told us, “There are regular meetings and our input is asked for”.