FitzRoy Supported Living - Uckfield

FitzRoy Supported Living Uckfield is a supported living service providing personal care to six adults with a learning disability and/or associated conditions, in one house and two bungalows to live independently in their own rented properties.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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.

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

Records still needed to improve in areas such as how complaints are formally recorded and end of life planning. Care plans were becoming person centred and detailed with information for staff to follow. The service was in the process of imbedding practices and sustaining improvements in these areas.

Since the last inspection there had been a significant change in atmosphere, culture and care. The provider had recognised the registered manager needed to be more available and on site to effectively support the required changes to ensure people’s quality of care improved. The registered manager said, “We have worked very hard to bring this back to a good service. Yes, there are things we need to do. Everything is organic and we will work hard to get this completed. We will work with the staff, people and their families to get it right.”

People told us they felt safe receiving the care and support provided by the service. Staff understood and could recognise the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk. Risk was identified and recorded with clear guidance for staff to reduce it as much as possible and people were assisted to access healthcare services when needed. Medicines were managed safely and administered by trained staff.

The atmosphere at the service now felt like a family home. People were free and eager to chat with staff and anyone who came to their home. There was a busy schedule which involved most people going out each day with staff to different activities. People were cared for by a staff team who were kind and thoughtful.

People's care and support needs were assessed before they started to use the service. Staff had the skills, knowledge and experience to support people appropriately. Staff were supported through induction, training and regular supervision. People were supported to maintain a healthy balanced diet and had access to health care professionals when they needed them.

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. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. 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, relatives and staff were engaged by the service through meetings, so everyone could contribute to the development of the service. There was a credible strategy in place with plans for staffing improvements at the service. This was being implemented by the registered manager who was pro-active in considering how the service could be improved.

Without exception people, relatives, professionals and staff spoke highly about the management and improvements to staff morale and team work. The registered manager had worked in partnership with health and social care providers to plan and deliver an effective service.

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

Rating at last inspection and update

The last rating for this service was Inadequate (published 22 July 2019) and there were four breaches of regulation. We imposed a positive condition, meaning the registered provider had to provide a report of the actions they intended to take to meet all the breaches of regulations. This report had to be submitted to the CQC on the first Monday of each month.

The provider completed this report each month and met the imposed positive condition. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since July 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.

We have found evidence the provider needs to sustain improvement. Please see the responsive and well led sections of this full report.

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.

Fitzroy Supported Living Uckfield is a supported living service that was providing personal care for six adults living with a learning disability.

People’s experience of using this service:

¿ People were not protected from the risk of avoidable harm. People were not protected from the risk of abuse.

¿ The service was not well-led, and the registered manager lacked oversight of the service. There had been significant shortfalls in the leadership of the service.

¿ The provider had reduced the management resource to the service and this had affected the quality of the service provided.

¿ Staff told us they did not feel valued in their roles and that there was a bullying culture within the service.

¿ Quality assurance processes were ineffective at identifying issues and improvements were not made to the quality of care people received.

¿ Risks to people were not always identified when people’s needs changed.

¿ Medicines were not always managed safely.

¿ People were not consistently treated with kindness, dignity and respect and their privacy was not always respected or maintained. ¿ Complaints were not dealt with in line with the provider’s policy.

¿ Staff did not have access to regular supervision and did not feel supported by the management team. Induction training for staff was inconsistent and the registered manager was not always assured of staff competency.

¿ Staff and the management team did not always work effectively with other professionals to ensure people’s needs were met in a timely way, specifically relating to raising potential safeguarding concerns.

¿ People had access to healthcare services when they needed them.

¿ People’s hydration and nutritional needs were met.

¿ People’s care plan contained person-centred detail and most staff knew people well.

¿ People and staff told us they were happier in recent weeks as the provider and registered manager had acted in relation to the safeguarding concerns.

Rating at last inspection:

Good (The last report was published on 30 November 2016). The rating at this inspection had deteriorated to Inadequate.

Why we inspected:

This was an unannounced responsive inspection. We brought this comprehensive inspection forward as we had received concerns from a variety of sources that included community health and social care professionals and whistleblowing concerns. Concerns were regarding the care people were receiving. There were several individual safeguarding concerns being investigated by East Sussex County Council in progress.

Enforcement:

We found four breaches of regulation. Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to the report after any appeals have been concluded.

Follow up:

The overall rating for this service is Inadequate and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the providers registration, we will re-inspect within six months to check for significant improvements.

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

FitzRoy Supported Living – Uckfield provides ‘supported living’ accommodation for people with learning disabilities in four flats and two bungalows to live independently in their own rented properties.

The service provides personal care seven days a week on a 24 hour basis to six adults with learning disabilities, mental health issues, physical disabilities and associated issues. Support is provided to people living in their own homes with tenancy agreements provided by Town and Country Housing Association. At the time of our inspection there were five people living at the service.

People had a choice about who provided the care in their homes. Two people in two of the other bungalows on the site no longer use the service as they chose to have support from a different provider. The service worked with them and social workers to select an appropriate alternative.

Staff promoted people’s independence by giving them choices and encouraging them to do as much as they could manage for themselves. People had sufficient opportunities to take part in person centred activities.

The service had a registered manager. 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 told us they felt safe receiving the care and support provided by the service. Staff understood and could recognise the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.

Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. People took an active role in the recruitment of potential new staff. There were sufficient levels of staff to protect people’s health, safety and welfare consistently and reliably.

People said staff were caring and kind and their individual needs were met. One person told us, “I love all the staff here.” Another person said, “All of the carers look after me. They are very good.” Staff knew people well and had a good understanding of their needs and choices.

People were supported by staff to write their own shopping lists and to shop for and prepare the food they chose. They were also supported to access a range of healthcare professionals in order to maintain holistic health.

Large print and easy read care plans and risk assessments reflected people’s assessed level of care needs and enabled people’s involvement in planning their care. People were encouraged to be as independent as possible. One person told us, “I do as I want here.”

Staff felt supported by management, said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service. A member of staff told us, “The management support me and listen to me.”

There was a comments and complaints policy and information regarding the complaints procedure was available. Complaints were listened to and investigated in a timely manner and used to improve the service.

Regular audits were in place to measure and monitor the quality of care and service provided.

People and staff surveys were positive about the service. One person told us about the support they were given to be independent and said, “What I have is lovely. I would recommend it.” A member of staff told us, “I think it is a fantastic place to work.”

We were invited to meet with people in their flats and permission was obtained from them first to check whether it was all right for us to do this. We saw that people had a plan of weekly activities and that they all went weekly food shopping. This enabled them to plan what they wanted to eat for the week ahead, make choices and take control of their lives. One person told us that they did not like sharing freezers, 'because I want to be independent in the kitchen'.

Care plans showed that comprehensive risk assessments were in place. People had their own link worker who met with them monthly to talk about any concerns or issues they might have and which might mean a change to the way their personal care was delivered. One person told us that she liked living here and that staff were, 'very good. I have favourite people.'

People's medication was kept in secure metal cabinets in their own bedrooms and records relating to the administration and storage of medicines showed that medication was kept safely and handled appropriately.

Staff were recruited following a set procedure and they were all vetted with regard to criminal records. People using the service were also involved in the interviewing process for new staff and no-one was recruited without their agreement. Staff received training and appropriate professional development. We found there were monthly team meetings, with support and development sessions.

People identified members of staff and they would talk to if they felt worried or had a problem. One person told us that they would talk to their key worker or the manager.

Staff we spoke to told us they enjoy working at the project. One personl told us "its really lovely". Another cited good staffing levels and training opportunities as positive features of their employment.

We saw evidence of safe, respectful and enabling practice by observation, records review and in discussions with individuals who use the service and a visiting healthcare professional.