Background to this inspection
Updated
12 January 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
One inspector and 1 Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in 7 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. We sought permission to meet other people and arranged the visit times around their appointments and activities. We also needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 14/11/2023 and ended on 21/11/2023. We visited the location’s office/service on 14/11/2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We visited 4 supported living tenancies and met 5 people. We saw people’s interactions with staff and if they were happy and comfortable in their presence. We looked to see if people’s homes reflected their personalities, met their physical and sensory needs, was clean and if the culture was caring and empowering.
During the inspection we spoke with 16 staff members and 5 relatives. This included 2 area managers, 2 team managers and a senior support worker. We met or spoke on the telephone with 10 support workers and emailed the registered manager.
We reviewed a range of records. This included 5 people’s support plans and several medication records. We looked at a variety of records relating to the recruitment of 3 staff, the management of the service, including policies and procedures, risk assessments and audits. After the inspection we looked at training data and quality assurance records and continued to seek clarification from the registered manager and management team to confirm evidence found.
Updated
12 January 2024
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
United Response - Fylde Coast Supported Living is a supported living service providing personal care to 15 people. At the time of the inspection there were 14 people receiving support in their own homes.
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.
People’s experience of using this service and what we found
Right Support:
People’s needs were assessed, and care plans were developed to promote positive risk taking. However, some people’s care documentation needed additional information or had passed their assigned review date. Staff were trained in the safe storage and administration of medicines; however, we noted some concerns that were addressed by the management team during the inspection. People’s homes and decor was personalised and reflected their personalities, showing their choices and decisions had been respected. Adjustments had been made in people’s homes to promote their independence and keep them safe. Staff were knowledgeable on what actions to take should they see any safeguarding concerns or hear any allegations of abuse. One staff member told us, “Staff are absolutely safe living here, safeguarding is our priority, keeping people safe our main role.”
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. When people lacked capacity to make specific decisions, we found the service was following the best interests principle. Relevant authorisations had been granted by the Court of Protection where people’s liberties were deprived.
Right Care:
The service had enough staff to meet people’s needs and keep them safe. Staff knew the people they were supporting well, including their health and wellbeing needs. Staff were trained and skilled to offer support and guidance to quickly lessen or minimise people’s distress. Staff and visitors were welcomed into people’s homes. Staff knew how to ensure people had the choice of eating a healthy diet.
Right Culture:
People had the choice of carrying out their daily living tasks and leisure activities in their local area. When people had chosen to opt out of certain tasks their decisions had been respected. Staff told us they could raise concerns with managers and feel safe and supported. People were comfortable and relaxed in the company of staff. People and staff had a friendly rapport and positive relationships had formed through the continuity of support. The management team worked alongside staff and with outside agencies to keep people safe and achieve their goals.
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 30 May 2018).
Why we inspected
We received concerns in relation to staffing, leadership and the management of risk and people’s care needs. As a result, we carried out a focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the Well-led sections of this full report. The provider has taken immediate action to address the concerns found.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for United Response - Fylde Coast Supported Living on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to systems and processes to ensure documentation is accurate and reviewed in line with the providers policy.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.