We carried out a review of the data available to us about Step by Step Supporting Independence Ltd 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 Step by Step Supporting Independence Ltd, you can give feedback on this service.
Step by Step Supporting Independence Ltd provides support to people with learning disabilities. The support is provided to people who live as tenants under a supported living scheme. At the time of our inspection the service provided support to 31 people living in their own homes. 21 people 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.
Step by Step Supporting Independence Ltd provides other services which help people to live independently, such as assistance with shopping and enabling people to undertake activities in the community. There is a log cabin facility in the grounds of its offices where staff support people with planned activities. People can also socialise with other people and staff in this area. For example, one person had recently enjoyed a big birthday party held in the log cabin.
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
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's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Staff received safeguarding training so they knew how to recognise the signs and symptoms of abuse and how to report any concerns of abuse. Risk management plans were in place to protect and promote people's safety. Staffing arrangements were suitable to keep people safe. Staff recruitment practices ensured staff were suitable to work with people. Staff followed infection control procedures to reduce the risks of spreading infection or illness.
The provider understood their responsibility to comply with the Accessible Information Standard (AIS), which came into force in August 2016.
Staff received induction training when they first started work at the service. On-going refresher training ensured staff were able to provide care and support for people following current practice.
Where the provider took on the responsibility, staff supported people to eat and drink sufficient amounts to maintain a varied and balanced diet. Staff supported people to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.
People had their diverse needs assessed, they had positive relationships with staff and received care in line best practice meeting people's personal preferences. Staff consistently provided people with respectful and compassionate care.
The service had a positive ethos and an open culture. The registered managers were visible role models in the service. People, their relatives and other professionals told us that they had confidence in the managers’ abilities to provide consistently good quality managerial oversight and leadership.
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 March 2017). At this inspection we found the evidence continued to support the rating of good, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why we inspected
This was a planned inspection based on the previous rating.
This inspection took place on 9 and 10 January 2017. The provider was given 48 hours’ notice that the inspection would be taking place. This was because the location provides a supported living service to people who are often out during the day; we needed to be sure that someone would be in.
The service was last inspected on 23 January 2014, when it was compliant with the regulations relevant at that time.
Two registered managers were 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.
Kind and caring staff ensured people received support that was responsive to their needs and as set out on their support plans. People were supported to attend a variety of events outside of their homes. Staff ensured people’s privacy and dignity was respected. Staff knew the people they supported well and ensured their preferences were met. Relatives were complimentary about the support provided by staff. One relative said “[person’s name] is happy living there, and that’s the main thing”.
People’s support plans described how staff were to support people. In particular they gave staff directions on how to manage any behaviours that may place the person or others at risk. Any risks to people were identified and plans put in place to minimise the risks. These risk assessments and management plans were used to support people to develop their independent living skills and become involved in leisure and educational activities to enable them to enjoy a more fulfilling life. For example, one person had wished to have driving lessons and had been supported to do so.
People’s support plans contained goals for each individual. One person told us how the service had supported them to become more independent and that had meant they needed less support.
People were supported to maintain a healthy balanced diet. They were supported to plan, shop for and prepare their meals. Staff ensured people’s health care needs were addressed. Everyone had an annual health check from their GP. People were supported to attend healthcare appointments when necessary.
People were protected from the risks of abuse. Staff knew how to recognise and report abuse both within the service and to outside agencies. Thorough recruitment procedures ensured the risks of employing unsuitable staff were minimised. Staff had a good understanding of the principles of the Mental Capacity Act 2005. However, there was no written evidence that people’s capacity to make decisions had been formally assessed, or that best interest meetings had been held where required.
Staff received training that helped them meet people’s needs. This included first aid and managing people’s specific health conditions. New staff received a thorough induction. Staff received regular supervision to support them in their role. Staff told us the registered managers were very supportive and approachable. One staff member told us “[Registered managers] are brilliant – can go to them about anything.” Staff told us they enjoyed working for the service. One said “I love working with the service users, it’s so rewarding.” Another told us the service was supporting them to progress their career in care.
There were quality assurance systems in place to monitor care. Regular audits were undertaken to ensure the quality of care was maintained. Records were generally well maintained. All records we asked for were kept securely but easily accessible. However, some records were incomplete, for example support plan audits and mental capacity assessments.
The registered managers ensured their knowledge was kept up to date by attending meetings and using the internet.
We have made recommendations relating to recordings and decisions relating to the Mental Capacity Act 2005.
We spoke with six people who use the service. we were told "I do well with staff support. They show me how to do things for myself". Another person told us "Staff support me when I'm anxious. Sometimes I don't know why I feel upset, but they help me until I feel better".
We spoke with two people who use the service who worked in the local community. One person told us that staff helped them to organise their day. The other person told us that staff have helped them to learn how to use public transport to get to and from work and how this has helped their independence.
We saw up to date care plans which considered individual needs. These plans contained risk assessments for all activities which were perceived to carry a potential risk. We saw that the service consulted with external agencies to access appropriate advice and support for each individual.
People were protected from harm and the risk of harm through staff training and detailed risk assessment of their daily activities. Staff we spoke with explained the safeguarding policy and procedure which included details of how to inform the safeguarding team and the Care Quality Commission as required.
We spoke with two people who used the service. They indicated that they were happy with the way staff cared for them and that they were supported to live well in the community.
People's consent to care was gained and we saw evidence that people received the care they needed. Staff had training in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) to ensure people's rights were protected.
We saw up to date plans of care which considered individual physical, emotional and mental health care needs. We saw risk assessments and that all documentation was kept up to date to ensure people had their changing needs met. We saw that the service consulted with specialists to ensure people had the benefit of expert advice.
People were protected from harm and the risk of harm through staff training and risk assessments. The service also referred safeguarding incidents to the local authority and to the Care Quality Commission as required