Archived: Inshore Support Limited - 88 Broad Street

Inshore Support – 88 Broad Street provides accommodation for up to four people living with a learning disability or autistic spectrum disorder. At the time of our inspection there were two people living in the home. One person was at the home on the day of our inspection visit, one person was in hospital. To protect people’s rights to a private life, the report will provide an overview of people’s experiences of living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the managers at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service and what we found

The service did not have a registered manager. Since the last inspection the registered manager had left the service. The provider had employed a new manager who was in the process of applying to register with us.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There were enough staff to keep people safe and to meet their needs. Staff understood their responsibility to safeguard people from harm and how to manage identified risks to people’s care. People received their medicines as prescribed and recruitment checks made sure staff were of suitable character to work with vulnerable people.

Staff received training and support to carry out their roles effectively. Staff knew people well, but recent staff changes had meant less consistency of staff for people living in the home. Regular agency staff were being used which provided continuity while recruitment of permanent staff was taking place.

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.

Staff encouraged people to maintain a balanced diet and respected their individual choices. The manager and staff worked with healthcare professionals to ensure people's health and wellbeing was maintained.

Staff and managers were caring and spoke positively about the people living in the home. People were comfortable within the home, they enjoyed spending time with the managers and staff and were able to follow their hobbies and interests.

People’s plans were personalised. Staff had time to read plans and were kept up to date about people’s care and support. People were involved in the running of the home and were provided with opportunities and information about making complaints.

Quality checks were carried out by the provider and manager to monitor the service, which identified where improvements could be made. The manager told us the lack of senior staff had restricted their availability to carry out quality assurance effectively.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was rated as Good (published 24 June 2017).

Why we inspected

This was a planned inspection based on the date and previous rating of the last inspection.

At the last inspection, in July 2014, the service was rated Good. At this inspection we found the service remained Good.

People continued to receive care in ways which helped them to remain as safe as possible. Staff understood risks to people’s safety and supported people receive their prescribed medicines safely. There was enough staff to provide support to people to meet their needs.

Staff received training which matched the needs of people who lived at the home, so they would develop the skills and knowledge to care for them. People made day to day decisions about their care and staff used their skills to make sure people were agreeing to the care offered to them. People were supported by staff if they needed help making key decisions about their life. People were cared for so they had enough to eat and drink and their food preferences were met. Staff supported people to see health professionals so they would remain well.

People enjoyed spending time with the staff who cared for them and were treated with dignity and respect. Staff spoke warmly about the people they cared for and encouraged them to make their own day to day decisions and maintain their independence.

People's care was planned in ways which reflected their preferences and wishes. Relatives’ and health and social care professionals’ views and suggestions were taken into account when people’s care was planned. No complaints had been made since our previous inspection, however, people, relatives and staff were confident if any complaints were made these would be addressed. Systems were in place to manage complaints.

People, their relatives and staff were encouraged to make suggestions to develop the care they received further through open communication with the senior team. The registered manager and provider regularly checked the quality of the care people received. Where actions were identified these were undertaken to improve people’s care further.

People were happy to be introduced to us. Some people spent time chatting to us, one person showed us around the home and their bedroom. Bedrooms were decorated in individual styles and reflected people's personalities and interests.

We observed people moving freely around the home making choices about how they wanted to spend their time. One person told us, "I'm going out today into town. I can choose if I want to go out."

There were adequate numbers of staff present to meet the needs of people who used the service. We saw there were three staff members in addition to the manager. The staff numbers allowed for individual attention for people whilst others were involved in activities outside the home.

During our visit we asked about the process for monitoring the quality of the service provided. We saw the home had good monitoring procedures in place. Evidence showed checks were regularly made on medication records, risk assessments and care plans.

There were three people living at the home. We were able to meet and speak to two people who used the service. People were happy to be introduced to us. Some people spent time chatting to us, one person showed us their room. Rooms were decorated in individual styles and reflected people's personalities and interests.

We asked people who used the service whether they were given choices. People told us "I can choose what I want to do." We observed people moving freely around the home making choices about how they wanted to spend their time.

People told us they were treated with consideration and respect. One person said "I've been here a while now and I like it." Another person told us "I get on well with everyone."

There were adequate numbers of staff present to meet the needs of people who used the service. We saw there were three staff members in addition to the manager. The staff numbers allowed for individual attention for some people whilst others were involved in activities outside the home.

During our visit we asked about the process for monitoring the quality of the service provided. We saw the home had good monitoring procedures in place. Evidence was available to show checks were regularly made on records and care plans.