Archived: Community and Housing Related Support Services Also known as The Pines

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 Care Act 2014.

Inspection team

The inspection team considered of one inspector and one Expert by Experience. 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 14 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection. Inspection activity started on 03 July 2019 and ended on 08 July 2019. We visited the office location on 03 July 2019.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We reviewed the information we held about the service including notifications the provider had sent to us. We contacted the local authority safeguarding and local commissioning teams to obtain their views about the service. We contacted Healthwatch for any feedback they had received. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. All this information was used to identify key lines of enquiry as part of the inspection.

During the inspection-

During the inspection we looked at four people's care records which included a wide range of support plans and risk assessments. We reviewed a range of documents relating to how the service was managed including; four staff personnel files, staff training records, policies, procedures and quality assurance audits.

We met with seven people living in the three supported living tenancies we visited. We obtained feedback from two people who were receiving support from the service and spoke with five relatives on the telephone to gain an understanding of their views of the service and quality of support that people were receiving. We spoke with the chief executive officer (CEO), two service managers, the director of human resources, quality manager, three team leaders and five support workers.

We last inspected the service in October and December 2013. At that inspection we found the service was meeting all the regulations that we reviewed.

Community and Housing Related Support Limited provides domiciliary care and support and eight supported living tenancies to adults, children and young people who have a learning and/or physical disability. The registered manager and additional management support staff were located at the company's head office in Hazel Grove Stockport Greater Manchester.

A registered manager was in place. 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 who used the service and their relatives were complimentary and positive about the support provided and attitude of the support workers. They told us they were happy with the service provided and felt their needs were being met. They also told us support workers treated them caringly, sensitively and with respect and they tried to make sure that their independence was maintained wherever possible.

People were supported by sufficient numbers of suitably trained staff. We saw that recruitment procedures helped to make sure staff had the appropriate qualities to protect the safety of people who used the service and we saw they received the training and support required to meet people’s needs.

Support workers we spoke with told us they had undergone a thorough recruitment process. They told us training appropriate to the work they carried out was always available to them and following their employee induction. This helped to make sure the care provided was safe and responsive to meet peoples identified needs.

Individual staff training records indicated that all support workers had received such training and were working towards a nationally recognised qualification in care such as a National Vocational Qualification (NVQ) in health and social care and the Care Certificate. The Care Certificate is a professional qualification which aims to equip health and social care staff with the knowledge and skills they need to provide safe care and support to people using the service. This qualification helped them to carry out their roles effectively. Support workers confirmed they had received safeguarding and whistle blowing training and knew who to report to if they suspected or witnessed abuse or poor practice.

Care records were in place to reflect peoples identified care and support needs. Information about how people wanted to be supported, their likes and dislikes, when support was required and how this was to be delivered was also included in the care records we examined. Information regarding people’s dietary needs was included in their care records and clear guidance for support workers helped make sure these requirements were met.

We saw written evidence of people and their relatives involvement in the decision making process at initial assessment stage and during their care needs review.

Medicines were stored safely and administered by staff who had been trained appropriately to ensure they were given safely. Any specific requirements in relation to medication, such as rescue remedies for the immediate treatment of epileptic seizures, were clearly documented so that support workers could administer the medicine appropriately and were aware of any risk following administration.

Where people who used the service did not have the capacity to make their own decisions, the service ensured that decisions taken were in line with the principles of the Mental Capacity Act 2005. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

Support workers at supported tenancies were visited regularly by the registered manager to check if people were satisfied with the service they were receiving and to make sure staff were carrying out their duties appropriately.

Complaints, comments and compliments were encouraged by the provider and any feedback from people using the service or their relatives was addressed by the registered manager. People spoken with knew how to make a complaint and felt confident to approach any member of the staff team if they needed to.

The registered provider had systems in place to monitor the quality of the service such as service user and relative surveys, to ascertain their views and opinions about their satisfaction of the service provided. Any feedback received was noted and used to make improvements to the service and the care and support being provided.

We visited the head office of the organisation and also visited one of the supported living properties. During our visits we looked at the individual assessment and support plans and support worker files.

We spoke with the registered manager during our visit to head office and spoke with the service manager by telephone. We spoke with two of the people who use the service and a support worker when we visited one of the supported living properties. We also spoke with two family members and three support workers by telephone.

People told us that they were happy with the care people received and were happy working for Independent Options.

One of the support workers told us 'Everyone is very approachable it is one of the things I like about the job' and a family member told us 'I feel so at ease with them I can tell them anything I need to'.

The Community & Housing Related Support Service provides five different types of service; Community Support Team (Adults), Community Children and Young People's Services and Supported Living; the remaining two services did not provide personal care and were therefore not inspected.

On the 18 September 2012 we visited one of the homes which was part of the Supported Living service. During our visit we were able to speak with two support workers and two of the people who lived there.

We also spoke over the telephone with one family member from each of the three services. Every one we spoke with said that they were happy with the service and had no complaints.

Comments we received from family members and people who used the service were; 'I couldn't wish for anything more, I am very pleased;' 'They (staff) are very good with me, I like to know what is happening and they explain things;' 'They always knock on my bedroom door;' 'I am pleased with the care and pleased with support workers.'