Waterlees Supported Living Service

Waterlees supported living service provides personal care to people living in their own flats in a sheltered housing complex. At the time of our inspection there were 15 people living with a learning disability and/or autistic spectrum disorder who were using the service. 7 people were receiving personal care.

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

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.

Right Support

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. Staff focused on people’s strengths and promoted what they could do through robust positive risk taking, so people led fulfilling and meaningful lives. People and their relatives confirmed this.

People were supported to maintain and pursue their interests and to achieve their aspirations and goals. People and relatives were able to describe the outcomes they achieved as a result of their care and support. Outcomes included development of independence and being actively involved in their local community. People received their medicines as prescribed. We identified some minor documentation issues around recording and monitoring of incidents of distress, which was rectified by the registered manager immediately.

Right Care

People received care and support from staff who knew them well and understood their individual needs and considered their preferences. Staff understood people’s individual ways of communicating and spoke about them with respect. Staff could recognise and report abuse and there were enough appropriately skilled staff to meet people’s needs and keep them safe. Staff supported people to stay safe and maintain their well-being.

Right Culture

The culture of the service was open and empowered individuals to express their views and be in control of their lives with the support of staff. People received support based on inclusion, respect and transparency. People and their relatives told us they felt confident to approach the management team and that their suggestions would be listened and responded to. A range of quality checks with oversight at provider level helped to maintain and improve the service and the lives of people supported.

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 8 June 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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 remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Waterlees Supported Living Service on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

People received safe care at Waterless Supported Living Service. The provider had protocols in place to safeguard people and minimise the risk of abuse and avoidable harm. There were sufficient numbers of staff on duty to meet people’s needs. Staff safely supported people with their medicines were required.

The support that people received complied with relevant legislation and guidance. Their freedom was not restricted. Staff had the skills and experience to fulfil the requirements of their role. They supported people with their nutritional needs and to maintain their health and wellbeing.

People were supported in a kind and compassionate manner. Staff took steps to empower people to express their views about their care. They respected people’s choices. Staff supported people in a way that promoted their dignity and privacy.

People had access to a range of educational, work and social activities. They were supported to raise any complaints or concerns they may have about the service. The staff team took steps to act on people’s concerns and improve their experience of the care they received.

The registered manager and the staff team had a shared commitment to provide a good standard of care to people. They worked collaboratively with other agencies to provide the support people required. They had systems in place to monitor the standard of care people received.

The service met the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection: Good; published 11 August 2016.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: ongoing monitoring; we will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Waterlees Supported Living Service provides personal care and support for people with learning disabilities in their own homes. At the time of our inspection 13 people were using the service. People’s flats and the provider’s office were located within the same building.

At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. 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.

People felt safe with the support offered. Staff could describe and understood their responsibilities to support people to protect them from abuse and avoidable harm. The provider dealt with accidents and incidents appropriately however, the recording of investigations was not always thorough. Risks to people’s well-being had been assessed. For example, where people could have shown behaviour that challenged, staff had guidance available to them.

People’s equipment was regularly checked and there were plans to keep people safe during significant incidents, such as a fire.

People were satisfied with the availability of staff and we found there to be enough to support people safely during our visit. Staff had been checked for their suitability before starting work for the provider so that people were protected from those who should not work in the caring profession.

Where people required support to take their prescribed medicines, this was undertaken in a safe way by staff who had received regular guidance. Staff knew what to do should a mistake occur when handling medicines.

People were receiving support from staff who had the appropriate skills and knowledge. Staff received regular training and guidance. For example, staff met regularly with a manager to discuss their working practices and to receive feedback to enable them to provide effective support to people.

People were being supported in line with the Mental Capacity Act (MCA) 2005. The provider had undertaken some mental capacity assessments where there were concerns about people’s ability to make specific decisions. Staff understood their responsibilities under the Act and appropriate support had been sought where they were looking to lawfully deprive a person of their liberty.

People chose their own food and drink and were supported to maintain a balanced diet. They had access to healthcare services when required to promote their well-being.

People received support from staff who showed kindness and compassion. Their dignity and privacy was being protected including staff discussing people in a professional manner. Staff knew people’s communication preferences and the provider had made information easier to read for those that required it. For example, pictures were used to aid people’s understanding of activities that people could choose to take part in. People were supported to be as independent as they wanted to be. For example, by looking after their own medicines. Staff knew people’s preferences and had involved people in planning their own support. Where people needed additional support, advocacy services and information were available to them.

People or their representatives had contributed to the planning and review of their support. For example, we saw that one person, at their request, was supported with a regularly reviewed plan, to undertake gardening as a hobby by having individual tasks to complete such as buying equipment. People had support plans that were person-centred and staff knew how to support each person based on their individual requirements. People took part in interests and hobbies that they enjoyed including voluntary work.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. This included how the provider would learn from complaints if one was received.

People were complimentary about the manager. People, their relatives and staff had opportunities to give feedback to the provider. For example, staff attended regular staff meetings where they could offer suggestions to improve the service. We saw that the provider took action where this was necessary following the feedback received.

Staff felt supported and received feedback on their work through individual meetings with a manager. Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to.

The provider was regularly checking the quality of the service. For example, checks of people’s care records were taking place to make sure they included the correct information for staff to follow.

The provider had aims and objectives for the service that were known by staff. This included promoting people’s independence. We saw examples of this incorporated into the practice of staff during our visit.

The manager was largely aware of their responsibilities. However, statutory notifications of significant incidents had not always been submitted to the Care Quality Commission as required by law.

One person who used the service told us, "I like living here.I feel safe. The staff are good. They help me with my personal care and help me prepare my meals." Other people told us, "Life is good here" and "we spend our time as we want." A relative told us, "My [relative] is well looked after and happy. The staff have been here a long time so there has been a continuity of care. The staff are brilliant at keeping me informed; the staff genuinely care. We can't fault the service."

People had been involved in decisions about their care and had a say about how the service was run. Staff understood people's needs and had a clear understanding about how people wanted to be supported.

People's flats were personalised to reflect their life interests and hobbies. People had been supported to be as independent as they wanted to be and to be involved in the wider community.

The provider had effective recruitment arrangements that ensured as far as possible that only people suited to work with vulnerable people were recruited. Enough suitably experienced and skilled staff were on duty to support people with their needs. Staff were supported through effective supervision and training.

The provider operated effective procedures for monitoring the service and taking account of people's views.

We found that the service had made improvements since our last inspection which had resulted in people having more opportunities for privacy. People who used the service told us that they had been able to participate in activities when they wanted and that no activities had been delayed or cancelled for reasons to do with the availability of staff.

New style support plans had been introduced to ensure that care and support had been more person centred than at the time of our last inspection. Staff had received refresher training in practicing dignity in care. We found that those actions had improved people's experience of the service. The service had also improved its processes for assessing and monitoring the quality of care people received.

We found that the service met the standards we inspected against.

One person we spoke with told us that they liked their flat and that they enjoyed domestic activities associated with living in it.. Some people reported that they felt that staff did not consistently attend to their having meaningful occupation. And we witnessed one instance when someone's request to plan a visit out was deferred by the member of staff as they were about to go off duty. People who used the service were not always spoken to with respect. Not enough care workers were on duty to meet all of the needs of people who used the service in a timely manner.