We carried out a review of the data available to us about Cobbett House - Supported Living Service on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cobbett House - Supported Living Service, you can give feedback on this service.
People’s experience of using this service and what we found
People felt safe and there was a positive approach to risk taking. Systems were in place to protect people from abuse. There were enough staff to support people and medicines were safely managed. Communal areas were clean, and staff had undertaken infection control training.
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. People were able to have support with meal preparation and to access health care services if needed. Staff were well supported and received a range of training to help them keep up to date with their knowledge and skills.
People had built established positive relationships with staff. Staff showed a caring approach and promoted people’s rights to privacy, dignity and independence. People were encouraged to give their views about the service and were able to direct their support.
People received a service that was tailored to their needs. People were encouraged to be as independent as possible but call for staff assistance when needed. Staff responded to people’s needs in a timely manner. People had a detailed, well written support plan, that was regularly reviewed and updated. People knew how to make a complaint and were encouraged to raise concerns if they were not happy with the service they received.
There was a clear ethos, based on independence, that was adopted throughout the staff team. A range of audits were in place to assess the quality and safety of the service. There was positive feedback about the registered manager. They had a clear overview of the service and people’s needs. However, there was no management structure and contingency plans had not been made in the event of the registered manager’s absence. We made a recommendation to address this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 6 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
This inspection took place on 10 January 2017 and we returned on 11 January 2017 to complete the inspection. This was an announced inspection which meant the provider had prior knowledge that we would be visiting the service. This was because the location provides a supported living service, and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.
The service had a registered manager in post, who was responsible for the day to day running of 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.
People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included “They [staff] give you good emotional support, but also look after you when you’re ill. There is always someone around”, “Staff promotes independence” and “The best bit about living here, is the independence”. Relatives said “I have no complaints. Staff are friendly and patient” and “X [family member] is well looked after. Since living here they seem to have more say in what they want.”
Systems were in place to manage risk and protect people from abuse. Staff were aware of their responsibilities and knew what actions they needed to take to ensure people were protected.
Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their roles and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.
People’s care records demonstrated that their care needs had been assessed and considered their
emotional, health and social care needs. People's care needs were regularly reviewed to ensure they received appropriate and safe care, particularly if their care needs changed.
People had a range of activities they could be involved in and some people had opportunities to complete voluntary work. People were encouraged and supported to develop and maintain relationships with people that mattered to them and avoid social isolation.
Staff felt supported by the registered manager who was approachable and available if needed. The registered manager regularly worked alongside staff and had a good understanding of the staff team and people who were being supported.
Is the service safe?
During our visit we looked at communal areas within Cobbett House, and in five out of the seven flats. We found that people were supported to maintain a clean and hygienic environment. We spoke with five out of the seven people using the service. People told us they received care and support from staff who knew their needs, and who provided care and support in a manner that respected their independence. People knew who to speak to if they felt they needed a change in the level of support they received.
Staff told us they understood their role in preventing and reporting abuse, and people using the service said that they were able to raise concerns.
We found an effective recruitment system was in place. We looked at three staff files and saw they contained completed application forms, evidence of a robust interview and evidence that identities and criminal records had been checked. We saw that staff received an induction and on-going training, and the staff we spoke with told us they could request further training.
Records showed that three people had been assessed as needing safety equipment for their beds, some weeks before our visit. The manager told us that funding had been requested, and following our visit informed us that they had been put in place. The provider might like to note that delays in providing people with safety equipment could place people at risk of harm.
Is the service effective?
The service aims to support people's independent living. We saw that support plans which identified people's abilities and their support needs were in place. People told us staff routinely checked if they were happy to receive care and support.
We found that people living at Cobbett House were able to socialise together in a communal living room. People told us that staff supported them to be active in the community.
We found that people had access to specialist support to manage their health needs. Records showed that the level of support people received was in line with their agreed plan. We saw that the care and support delivered by staff had been recorded and met their needs. The manager told us they monitored these records on a weekly basis.
Is the service caring?
People who use the service spoke positively about the staff, and the support they received. One person said 'staff are always willing to help me' and another said 'staff are kind and friendly'. People told us they felt staff knew them well and understood their needs.
Is the service responsive?
People we spoke with told us about some of the things in their life they found important, and identified some of the ways staff supported them in these areas. For example, we saw that one person could no longer access an activity they enjoyed, and staff were exploring whether there were any alternatives available.
People told us they understood the complaints process, and records showed that people had been reminded of it at the previous two tenants meetings. Staff told us that people were encouraged to complain and people we spoke with told us they were happy that anything raised was dealt with efficiently. We found no complaints had been recorded. The manager told us they would discuss this further with staff to ensure all concerns raised were recorded appropriately.
People using the service had access to regular tenants meetings, and records showed that action was taken in response to anything raised in them.
We saw that people's support plans were up-dated in response to changes, but the provider may find it useful to note that not all sections within people's support plans had been reviewed. This means people could receive support that was not in line with their current needs and wishes.
Is the service well-led?
The manager told us they were currently providing more direct care than they would normally, due to a member of staff leaving. A new member of staff had been recruited and was due to start in July. On the day of our visit we saw they had come to meet with the trainer.
We found that the manager understood the needs of the people using the service, and the staff we spoke with told us they felt supported within the team. The manager told us they were also supported by their Head of Operations. We saw that staff had access to on-call support at all times and an emergency plan was in place. We saw that each person using the service had a personal evacuation plan in place.
We found a number of quality assurance measures were in place. These included the monitoring of people's views on the service, health and safety and Medication Administration Records audits.
People gave us examples of how staff respected their privacy and independence. For example, waiting for permission to enter their flat and to support them to go to bed at their preferred time. Staff were aware of the importance of enabling people's independence.
We saw people's care was provided in line with their support plans. Care records were comprehensive and overall reflected people's needs. People's care records and medicines charts were accurately maintained. Staff had received the appropriate training to support people with their medicines.
The provider had a system to regularly assess and monitor the quality of service people received. The manager understood their role and responsibilities with regards to notifying incidents which affected the care and welfare of people using the service.
People's privacy, dignity and independence were not consistently respected. We were told staff did not always knock on people's flat doors before entering. Some people were not able to go to bed at the time they preferred.
There were enough staff to provide appropriate support. Staff understood how to recognise and report abuse. We saw staff had received some essential training. We saw some medicines records were difficult to read. Some staff had not updated medicines management training for several years.
The provider's system for monitoring quality and reporting incidents and accidents was not sufficient. Records were not accurately and consistently maintained.