Background to this inspection
Updated
5 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 8, 9 and 15 January 2018. The inspection team consisted of one adult social care inspector.
Before the inspection, the registered provider completed a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
We liaised with Trafford and Stockport local authority contract monitoring teams and adult safeguarding teams to obtain their feedback about the service. We used this information to assist with our inspection planning. We also contacted Healthwatch Trafford. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
To find out how staff supported the people, we visited people in their flats when staff were there (with people's permission). We visited three supported living accommodations which included Orchard Court, Daresbury Close and Highfield Avenue. We spoke with eight of the people using the service and one person’s relative, the registered manager, one deputy manager and nine support workers. On the 15 January 2018 we spoke with six people's relatives by telephone.
As part of the inspection we reviewed five people's care files, four staff personnel records, various policies and procedures, staff training records, four people's medicines administration records, audit and monitoring records and other documents relating to the management of the service.
Updated
5 February 2019
We inspected FitzRoy Supported Living –Trafford on 8, 9 and 15 January 2019. The first day of the inspection was announced. The provider was given 24 hours' notice of the inspection because the location provides a community-based service and we needed to be sure someone would be available.
This service provided care and support to people living in 'supported living' settings. In supported living, people live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; we looked at people's personal care and support. At the time of this inspection the service was providing support to 19 people in four 'supported living' settings for adults over 18 years, people living with learning disabilities, physical disabilities and/or autistic spectrum disorder and people with sensory impairments.
At the last inspection in November 2017, there were three breaches of legal requirements in relation to the Mental Capacity Act 2005 in respect of assessing people's capacity, auditing systems had identified issues with the quality of the service, but these were not always being addressed in an effective way and we found the registered provider had not ensured that there was always enough staff to meet people's needs. At this inspection we found the requirements had been fully met.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in post. 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 also supported by a service development and implementation manager and two deputy managers.
Since our last inspection we found noticeable improvements in developing new systems for audit and quality assurance. A new suite of audit tools had been introduced covering key aspects of service delivery.
Prior to our inspection we were notified in June 2018 by the provider they had made a safeguarding referral and contacted the Police due to finding a significant amount of money missing from people’s bank accounts at one of the supported living services. As a result of an internal investigation the provider found significant failures in respect of the registered and deputy managers finance checks of people’s monies. At the time of this inspection the Police were still conducting their inquiries in respect of the allegations of theft against a staff member and the provider made a timely referral to the Disclosure and Barring Service (DBS). The provider also reimbursed all monies that were stolen from people and the auditing of people’s finances was fully reviewed by the provider, which resulted in thorough checks being completed on all financial transactions at the service and the other three supported living services.
At the last inspection we found the provider did not have a clear overview of the staffing hours being provided at Highfield Avenue. At this inspection we found the staffing levels were being appropriately deployed across all of the four supported living services. There were enough staff to support people and the provider carried out checks to make sure new staff were suitable to work in the service.
At the last inspection we found staff had limited understanding of the Mental Capacity Act (MCA) and required mental capacity assessment were not always undertaken. At this inspection the provider understood their responsibilities under MCA and refresher training had been provided to staff. During the inspection we saw that people were not deprived of their liberty unlawfully and the appropriate applications to the court of protections had been made.
People told us staff treated them with dignity and respected their privacy. We found staff knew the people living at the home well and they were able to talk in depth to us about people's needs, preferences and social histories. Staff interacted well with people and were quick to act to make sure people were comfy and received the support they needed.
Medicines were managed safely and people were encouraged to be as involved as possible with their medicines. Room temperatures where medicines were being stored were now being consistently recorded to ensure medicines didn’t spoil and remained below the recommended temperature.
Support staff completed training the provider considered mandatory. The provider also arranged training specific to the needs of the people using the service. Support staff also told us they found the provider's training helpful. Staff had the supervision and support they needed to work effectively with people using the service.
The provider had an easy read complaints procedure that used pictures to make the process easier for some people using the service to understand. The registered manager had a better oversight of received complaints and we saw they investigated all complaints in line with the provider's procedures.
Activities at the service continued to be limited due to budget constraints. People relied on their personal budgets to support with activities. However, we did see attempts when possible where staff would support people to have meals out and access the local community.
It was clear at this inspection the registered manager demonstrated a renewed commitment and willingness to improving the quality and safety of care provided by FitzRoy Supported Living –Trafford. The registered manager also greatly benefited with the support from the providers service development and implementation manager who also supported with audits at the service.