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Inspection carried out on 14 June 2018

During a routine inspection

This service provides supportive living and provides personal care to people living in their own houses. It provides a service to disabled adults with sight and hearing impairments, along with other disabilities. This service provides care and support to 33 people living in nine 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.

At our last inspection we rated the service as good overall with a breach of Regulation 17. The provider did not have robust systems in place for monitoring the quality of the service. At this inspection we found the evidence continued to support the rating of good. The provider had improved systems to monitor, assess and improve the quality of the service.

The service had recently appointed a new manager, who had been there ten weeks and was currently going through the application process with the Care Quality Commission to become the registered manager of 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.

Systems and processes were in place to mitigate risks relating to the health, safety and welfare of the people who used the service. Staff understood their responsibilities and completed regular monitoring and checks related to maintaining the health and safety of the environment for the people using the service. Staff had completed safeguarding training and were able to tell us the action they would take if they suspected abuse was taking place. Policies and procedures informed staff of how to raise concerns.

People who were able were fully involved in reviewing their care needs and support. Staff received regular training, appraisals and competency checks to keep their knowledge and understanding of people’s needs up to date. Staff felt supported and received regular supervision meetings. Staff demonstrated good understanding of people’s needs and were confident within their individual roles. People told us staff were caring and how their wellbeing had improved from the support they have received.

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 support this practice.

Detailed care plans contained person-centred information and was updated and reviewed on a regular basis. We saw good interactions from staff. Person centred communication methods were used to support people with their everyday needs.

People were supported to plan and maintain a healthy diet.

A new electronic system was being implemented to make care plan information more accessible for people. Daily monitoring of people’s health needs was recorded in detail. Support and advice was sought from health professionals promptly when this external input into people’s care was needed.

The provider had a manager in place who had been working at the service for ten weeks. The provider and management team had a clear vision of improving the lives of people with sensory impairments and learning disabilities. Staff enjoyed working in the service and said, “We are like family, I really enjoy coming to work. It is not like a job.

Further information is in the detailed findings below.

Inspection carried out on 29 June 2016

During a routine inspection

We inspected this service on 29, 30 June and 7 July 2016. The inspection was announced. The registered provider was given 48 hours' notice because we needed to be sure that someone would be in the location offices and supported living services when we visited.

The Wilberforce Trust is registered to provide personal care to people living in their own homes and specialises in supporting people living with a visual impairment. Some of the people using the service also have a learning disability or physical disability. At the time of our inspection there were 31 people using the service, living across nine supported living houses and bungalows; six within York and three in Tadcaster. The Wilberforce Trust also owned the properties that people lived in, but the properties were managed separately by a facilities manager and people who used the service had a tenancy agreement.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). 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.

Feedback about the management of the service was positive and staff told us they felt supported. People using the service, and visitors that we spoke with, reported that they were very satisfied with the care provided by registered provider. We did however find that quality assurances processes were not sufficiently robust; there were inconsistences in the recording of information about accidents, incidents and issues, and a lack of evidence of audits completed and used to drive improvements. This was a breach of Regulation 17 (2)(a)(b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

During the inspection we found there were systems in place to support staff to appropriately identify and respond to signs of abuse to keep people safe. Risks were identified and steps taken to minimise risks to keep people safe.

There were safe recruitment processes in place so that only people considered suitable to work with vulnerable adults were employed. There was on-going recruitment and monitoring of staffing levels to ensure that people's needs were met.

Medication was managed and administered safely.

Staff received a comprehensive induction, refresher training and on-going support in their role. Staff sought consent to provide care in line with legislation and guidance, but records in relation to this could be clearer in some cases and not all staff had received training in relation to the mental capacity act. We have made a recommendation about this in our report.

People were supported to eat and drink enough and were supported to access healthcare services where necessary. Records showed that staff were following the guidance of healthcare professionals.

We received positive feedback about the caring nature of staff. Staff were observed to be warm, friendly and attentive to people's needs. People had developed caring relationships with the staff who supported them. We found people were supported to make choices and have control over the care and support they received. People also told us they were treated with dignity and respect.

Support plans contained person centred information and staff were knowledgeable about people's needs and preferences. People who used the service communicated in a variety of ways and we saw staff were familiar and adept at using people's preferred means of communication, and took account of their visual impairment.

There was a system in place to ensure people could raise concerns or make a complai

Inspection carried out on 22 August 2013

During a routine inspection

People we spoke with said that they were informed about the service they could receive and were able to ask questions before they gave their consent for a service to be provided.

We saw that people had individualised support plans and risk assessments in place which helped staff to understand and meet people's needs. Everyone we spoke with told us they were happy with the care and support they received from the staff. One person we spoke with said �The staff talk about the care before they do it. The staff read from my file what I can and cannot do for myself. This works well.�

There were policies and procedures in place to help to protect people from abuse. Staff knew what action they must take if they suspected abuse was occurring. This helped to keep people safe from harm. One person we spoke with said �I feel safe with the staff.�

There were enough skilled and experienced staff to meet people�s needs. This was confirmed by people we spoke with and from information gained from two completed questionnaires. A person we spoke with told us �Staff are there to support me at any time.�

The quality of the service being provided was being monitored by the management team. Any issues found were being acted upon. This helped to ensure that people remained satisfied with the service they received.

Inspection carried out on 3 October 2012

During a routine inspection

People's needs were assessed and their rights were respected by the staff. People made decisions about how they wanted to spend their time. We saw staff treating people with dignity and respect. During our visit we spoke with some people they said �I get up and go to bed when I like." Another person said �I choose what I want to do." We saw some people had completed surveys. These helped to confirm people's rights were being protected.

People had support plans and risk assessments in place which helped staff to understand and meet people's needs. We saw staff helped people to maintain their independence and make choices for themselves. A person said �I see a doctor if I am unwell." Other people gave a thumbs up sign when asked if they got the care they needed.

Most people could not tell us if their medicines were handled appropriately. We visited some people and saw that there were robust systems in place. One person said �Staff help me with my tablets."

People we spoke with could not tell us about how staff were recruited. However, they were able to give a thumbs up sign or say in basic sign language that staff were good to them. One person said �The staff are nice." We saw that thorough recruitment processes were in place.

People's views were being sought about the quality of the service provided. We saw that the management team acted upon any issues to make sure that people remained happy with the service they received.

Inspection carried out on 1 September 2011

During an inspection looking at part of the service

The people living in the two houses we visited were unable to talk with us about what it was like to live there, because of their communication difficulties. At a previous compliance review in May 2011 the support staff we spoke with were able to explain to us what people�s different behaviours may mean. We saw this information was also recorded in their support plans.

Inspection carried out on 19 April 2011

During a routine inspection

Those people who were able to speak with us said they were very satisfied with the support they received. They lived active and fulfilling lives and made comments like �we have the opportunity to say if we don�t agree with something. The staff provide good support and listen to us. They always knock on our doors (of our rooms) and wait to be invited in�.

Some people though are unable to communicate their views. We saw support staff talking to people in a gentle and respectful manner, and found that they recognised people�s different behaviours and what they meant.

These people�s support plans though clearly stated how they would like to spend their time and these preferences were generally not being met, so their lives were not so enriched.