The inspection took place on 19 and 20 September 2016 and was announced. The service provides supported living and an outreach service to adults with a learning disability. The outreach service is provided by the same staff team and management as the supported living service. At the time of our inspection 26 people were using the service.
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.
Staff had received training and understood how to recognise signs of abuse and the actions they would need to take if they suspected abuse had happened.
When a risk had been identified actions had been put into place to minimise the risk in the least restrictive way, this had been regularly reviewed. People had been involved in decisions about their risks and their freedom and choices had been respected.
People were being supported by enough staff to meet their assessed needs. Staff had been recruited safely. This had included a criminal check being completed and two references being obtained to verify employment history.
People had their medicine stored, ordered and administered safely. Staff completed medicine administration training and staff training records showed us that their competencies had been checked.
People were supported by staff that had completed an induction and on-going training, including training specific to peoples individual health needs. This enabled them to carry out their roles effectively. Staff told us they felt supported in their roles. Staff had regular supervision, an annual appraisal and opportunities for personal development.
Staff understood the need to obtain people’s consent before providing support. When people had been assessed as not having the capacity to make certain decisions a best interest decision had been made in line with the Mental Capacity Act.
People were supported by staff who knew their eating and drinking requirements. When risks had been identified the appropriate actions had been taken. People had access to healthcare services. We saw that this had included GPs, opticians, dentist, psychiatrists and the community learning disability team.
People and their families described the staff as caring. We observed people enjoying a relaxed and friendly relationship with staff, laughing and enjoying time together. Staff had a good understanding of people’s interests, likes and dislikes and were having conversations with people about things that were important and of interest to them. Different methods were used to support people communicate their choices and wishes. People and their families were involved in decisions and advocacy services were available to people if they wanted independent support with decisions. Staff respected people’s right to privacy and dignity and supported people to be as independent as possible.
People had individual support plans that provided information about the person and how they needed to be supported. Support plans were regularly reviewed. People’s changing needs were recognised and responded to appropriately. People enjoyed a wide range of activities both in their home and in the wider community which reflected their likes and interests. Staff supported people to maintain links with their families and friends. .
A complaints process was in place and people and families felt if they used it they would be listened too. Any concerns raised had been appropriately addressed by the registered manager.
Staff spoke enthusiastically and held positive views about the organisation, management in the supported living homes and the wider local management of the service. Staff meetings were held at several levels and provided opportunities to share views, ideas and information. Staff had a clear understanding of their roles and responsibilities and were confident and professional in their interactions with team colleagues and the people they were supporting.
The registered manager had a good understanding of their responsibilities for sharing information with CQC and our records told us this was done in a timely manner. Auditing processes were in place at an organisational, regional and local level. These audits gave enough information to determine quality standards and had led to positive changes for people. A quality assurance survey took place annually and captured views of people, their families, staff and other professionals with experience of the service. The provider had yet to share the results.