Archived: Independent Living Alliance - Manchester

Updated 29 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 11 October 2016 and was announced. We gave the provider short notice of the inspection to ensure there would be staff available who could access the records. We also wanted the people who lived at the service to be made aware of our visit. The inspection was conducted by one adult social care inspector.

Prior to the inspection we reviewed all of the information we held about Independent Living Alliance – Manchester, including any statutory notifications that the provider had sent us and any safeguarding information we had received. Notifications are sent to us by providers in line with their obligations under the Care Quality Commission (Registration) Regulations 2009. These are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of.

On this occasion, we asked for a Provider Information Return (PIR) prior to the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. All of this information informed our planning of the inspection.

During the inspection, we spoke with all four people who lived at the service who were being supported 24 hours a day by staff. We also spoke with the registered manager, a team leader and two care workers. We were able to observe care delivery in communal areas such as medicine support and mealtimes and we were invited to look into three bedrooms. We reviewed a range of care records and the records kept regarding the management of the service. This included looking at one person’s care records in depth and reviewing the other three, five staff files and other records relating to the safety and quality of the service.

Updated 29 November 2016

Independent Living Alliance – Manchester is a community based service which provides supported living services to four people in one property. The service was previously inspected in 2014 where the provider was found to be complying with the outcomes we inspected. This inspection took place on 11 October 2016 and was announced.

There was a registered manager in post who had been registered with the Care Quality Commission (CQC) to carry on a regulated activity since July 2015. A registered manager is a person who has registered with CQC 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.

The people we visited told us they were happy living in their home and felt safe being supported by the staff both at home and in the community. The registered manager and the staff had a good understanding of safeguarding procedures. They were fully aware of their responsibilities with regards to protecting people from abuse or improper treatment. Incidents of a safeguarding nature had been dealt with appropriately and referred to the local authority. Policies and procedures were in place to ensure the service was operated well.

There were enough staff employed to ensure the people’s needs were met. Team leaders and service managers were employed throughout the provider’s organisation to ensure all services were run safely and effectively. At the time of inspecting this service, there was a vacant service manager’s post. The provider had a rolling recruitment programme to build up a bank of care workers to cover in the event of absences across all services. There was a robust recruitment process in place and we confirmed this process was followed when we reviewed staff records. Staff told us they worked regular shifts and we saw their rotas were planned in advance. This demonstrated people received a flexible, consistent and reliable service.

Care records were very person-centred and contained personalised information. Individual care needs had been assessed and the risks people faced were documented with strategies and actions for staff to follow in order to mitigate those risks. We saw care records were regularly reviewed and updated.

Accidents, incidents and near misses were recorded, investigated, reviewed and monitored by the team leader and overseen by the registered manager. The registered manager was aware of her responsibility to report certain incidents to external bodies, such as the local authority and CQC as necessary. However we found one notifiable incident which had not been sent to CQC. We asked the registered manager to do this in retrospect, which she did.

Medicines were managed well and staff demonstrated that best practice guidance was followed. We observed staff administer medicines in a safe, timely and hygienic manner. Medicine Administration Records (MARs) were used to record when assistance was given. We saw these were legible, accurate and up to date.

The provider had an up to date induction process in place and staff records confirmed they had completed the induction and had shadowed experienced workers. Training in topics which the provider deemed mandatory had been undertaken, such as safeguarding, safe handling of medicines and food hygiene. Specific training in autism awareness, epilepsy and positive behaviour management had been resourced as this was relevant to meet people’s needs. Formal staff supervision sessions, including a probationary review had taken place as well as annual appraisals and regular job chats.

Staff meetings were held every three months with the care workers; monthly team leaders and service managers meetings took place across the provider’s organisation. The staff we spoke with told us they felt supported and valued at work by the management team.

The registered manager and staff displayed an understanding of the Mental Capacity Act 2005 (MCA) and their own responsibilities within its principles; staff had completed MCA training and people’s mental capacity had been assessed. There was evidence that decisions had been made in a person’s best interests with the involvement of relevant others, including through the Court of Protection.

Staff supported people to maintain a well-balanced diet. Most people were supported to shop for and prepare meals depending on their abilities. People were given choices and assisted to plan menus for the week ahead. Staff had been made aware of allergies and food intolerances as well as likes and dislikes. We saw evidence that staff involved external professionals as required to provide input into people’s care.

The atmosphere in the service was calm and relaxed. The staff we spoke with were friendly, caring and professional. They spoke with affection about people they supported and obviously knew them very well. The information they told us matched the information we read in people’s support plans. Staff told us how they respected people’s privacy and maintained their dignity during personal care and we observed them speaking politely to people throughout the inspection. Daily notes recorded by staff reflected caring and respectful values. ‘Personal choice’ reviews were completed with people on a regular basis. These reviews measured the person’s involvement in choices and decisions.

There had been no complaints made about the service. We reviewed the provider’s complaints policy and saw the registered manager had ensured the complaints procedure was shared with people and on display in communal areas. The people we spoke with told us they had no complaints.

There was evidence that the service sought the views of people and their relatives about the service they received. Satisfaction surveys were issued to people and staff for their opinions. Other stakeholders, such as local authority care managers and external professionals were also asked for feedback.

The records we reviewed were accurate and up to date. Records containing people’s personal information were stored securely. Staff records were kept at the provider’s office. Regular audits of the service were carried out by the team leader and evaluated by the registered manager. Provider audits were carried out by representatives from the provider organisation. This demonstrated the provider and the registered manager had oversight of the service and they monitored it for safety and quality.