We carried out a review of the data available to us about Melton 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 Melton Supported Living Service, you can give feedback on this service.
At the time of our inspection there were 13 people using the service.
The service supports people in five shared properties close to the office building. Night time support is provided by waking night staff, or sleep-in staff, in some of the properties. Properties without night time staff support have remote sensors in place which can summon assistance from waking night staff, in the nearby properties, if needed.
People’s experience of using this service:
People received kind and caring support from staff who knew how to meet their needs. We observed staff talking kindly to people and treating them with respect.
People were supported to take their prescribed medicines and care staff followed systems and procedures to ensure medicines were administered safely.
People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
There were sufficient care staff available to provide safe support and necessary pre-employment checks had been carried out.
The registered manager ensured that people’s care plans and risk assessments were amended following incidents to ensure that people were supported safely.
There were systems and processes in place to safeguard people from the risk of abuse.
Care plans were in place which were updated as people’s needs changed. This meant that the care plans guided care staff to effectively meet people’s needs.
Care staff were well supported by the provider. They received suitable induction, training and had the skills and experience necessary to support people safely and effectively.
People were supported with their dietary needs and to get medical attention when they needed it.
People had personalised plans of care which gave staff the knowledge and information to support them in a way that people preferred.
The registered manager worked in partnership with others to ensure people received safe care and support.
People had the choice to engage with a variety of activities including local community social groups.
People, and their relatives, told us that the registered manager was approachable, and that any concerns they raised had been dealt with effectively.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The registered manager had a quality assurance system in place to monitor the safety and quality of the service.
Rating at last inspection: Requires Improvement: 11 June 2018
At the previous inspection we found that the service was in breach of Regulation 18; Registration Regulations 2009: Notifications of other incidents. The provider had failed to notify safeguarding incidents to CQC as is required by law.
Additionally, improvements were required in the handling of accidents and incidents. Care staff had not completed regular and effective training and improvements were required to the auditing of care plans and risk assessments to ensure they contained current information.
The provider had made the required improvements in all these areas.
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor the service through the information we receive.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At our last inspection in February 2016 the service was rated overall Good. At this inspection we found that the service had deteriorated and received an overall rating of Requires Improvement.
This inspection took place on 10 and 11 April 2018 and was announced. At the time of the inspection the service was supporting 13 people with their personal care needs.
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.
Improvements were required to the handling of safeguarding incidents, and to accidents and incidents within the service. Investigations into these matters were delayed and ineffective at ensuring prompt action was taken to prevent similar issues and concerns occurring again.
Improvements were required to ensure that staff completed regular and effective training. Staff were not effectively monitored to ensure they completed their training in a timely way, and this was of concern at our last inspection and sufficient action had not been taken to resolve this.
Improvements were required to the auditing systems that were in place to ensure they were effectively reviewing people’s care plans and risk assessments; and that when actions had been identified they were actioned promptly. In addition, improvements were required to the records of people’s care to ensure they were accurate and contained current information and guidance.
The registered manager operated good recruitment practices and people were supported to take their medicines as independently as possible. There were adequate numbers of staff on duty to keep people safe and people had risk assessments in place which encouraged their independence and kept them safe.
People were actively involved in decisions about their care and support needs and there were systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People’s nutritional and healthcare needs were regularly monitored and staff were given regular supervision.
People were treated with care, compassion, and respect. Staff treated people well and each person was supported in a way that was individual to them. People were treated with dignity, respect, and kindness. People were able to maintain their independence with the support of staff.
People and their relatives were involved in completing comprehensive assessments when people began to use the service and people’s care packages were designed around each person’s individual needs, styles, preferences, and values. People were supported to follow their interests and procedures to manage complaints had been established and people and their relatives were aware of how to raise concerns if they needed to.
At this inspection we found the service to be in breach of one of the Care Quality Commission (Registration) Regulations 2009 (part 4) and we are considering our criminal enforcement actions.
Melton Supported Living Service provides domiciliary care for up to 21 people with learning disabilities in their own homes. At the time of our inspection 21 people were using the service. The service is provided in different accommodation types including flats and bungalows. These were located near to the office where the registered manager was based.
It is a requirement that the service has 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. At the time of our inspection there was a registered manager in place.
People felt safe and staff knew about how to protect them from harm and abuse. The provider had a range of risk assessments in place to keep people safe although some needed reviewing. The registered manager had made arrangements to check equipment regularly.
People who showed behaviour that could challenge had plans in place to support them. Some staff needed an update to their training in this area. Accidents and incidents had been carefully looked at to try and stop them from happening again.
There was a plan for staff about what to do in an emergency. This included how to support people to evacuate their homes.
Staffing levels were appropriate to keep people safe and the provider had a thorough recruitment process in place. This included checking the suitability of staff before they had started working for the provider.
People received their prescribed medicines. Where people handled their own medicines, there were systems in place to support them to do this safely.
People received support from staff who had undertaken regular training. Some of this training needed updating. For example, where people had specific conditions that required specialist training, this was not always up to date. The registered manager made plans after our visit to make sure this would happen. Staff met with their managers and received regular support.
People were supported to make their own decisions where they could. However, where people may have lacked the capacity to do this, the provider had not carried out mental capacity assessments or best interest meetings. We were given information after our visit to show how this was going to be improved immediately. Staff showed a good understanding of the Mental Capacity Act 2005 and had received training in this area.
People had access to food and drink that they preferred and were encouraged to eat healthily. Where there were concerns about a person’s weight, specialist advice had been sought. People had access to a range of healthcare professionals such as their GP.
People told us that staff members were caring. We saw staff responding well to people. People’s independence was being encouraged and people told us that this was important to them. Staff knew about people’s communication needs and we saw staff meeting these when we visited.
Staff knew about people’s preferences and interests including their cultural needs. For example, one person liked listening to hymns.
People were involved in planning their own care where possible. We saw that people were given choices on a daily basis about things that mattered to them. For example, one person was supported to choose what they wanted to wear.
People were being treated with dignity and respect. For example, information held and shared about people was being undertaken in a careful and sensitive way.
People were involved in the assessment of their own needs where they could. Where they could not, others had been involved such as family members. People’s needs had been regularly reviewed.
People had support plans that contained information about their preferences and things that were important to them. For example, people’s routines were documented and we saw staff following these when we visited.
People were taking part in activities that they enjoyed. For example, people had been supported to go on holiday.
People knew how to complain and there was a complaints procedure available to them. Any concerns that had been received by the registered manager had been investigated.
Staff told us that they felt supported by the registered manager. Staff could offer suggestions for improvement through the regular staff meetings that had occurred.
Staff knew how to raise concerns about their colleagues and there was a clear policy in place for doing so.
The registered manager had sent questionnaires to people who used the service and their relatives to gain feedback on the service offered. There were also audits of the service. However, these required attention to make sure that they were regular.
The registered manager was aware of their responsibilities. For example, they had taken action following a safeguarding incident.
Relatives were also satisfied with the service. One relative said, 'The quality of life for people is excellent and the care individualised. My (family member) often says what a pleasure it is to be cared for by this service. They are just so happy.' Another relative commented, 'The service has exceeded our expectations. Staff have gone out of their way to help our (family member) settle it.'
People told us staff consulted with them to make sure they were happy with the support provided. One person said, 'The staff ask me if I'm happy with them and I say I am. If I didn't like any of the staff I would go to the office and tell the boss.'
Relatives said the manager worked hard to ensure the service was of a high standard. One relative told us, 'I trust the manager. She's on the ball and very keen to get things done. If you raise something with her she deals with it.'
Some improvements were needed to care plans and staff training and the manager said she would address these.
When we spoke with staff they were aware how to support people and this reflected the support plans we viewed at the time. We saw staff were subject to a secure recruitment process prior to commencing their employment. We also saw that staff are thoroughly trained to enable them to support the wide variety of peoples needs, all of which points to ensuring peoples' safety.