You are here

Paradise Independent Living Requires improvement

Reports


Inspection carried out on 20 September 2019

During a routine inspection

About the service

Paradise Independent Living is a supported living service providing personal care and aims to support and rehabilitate people with acquired brain injuries. At the time of the inspection, 14 people were using the service in three supporting living settings.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, we found instances where people were subjected to restrictions and prompt action had not been taken by the provider to ensure any potential deprivation of liberty was lawful.

Medicines were not managed safely. There were no clear individual protocols for people receiving ‘as and when required’ (PRN) medicines.

Personal Emergency Evacuation Plans (PEEPS) for people using the service were not individualised in accordance to people’s needs.

There were systems in place to assess and monitor the quality of the service provided. However, these were not always effective and did not identify the shortfalls found during this inspection.

People and relatives spoke positively about the service. They told us they felt safe and their needs were being met. Risk assessments were in place to prevent or reduce the risk of people being harmed. Staff followed appropriate infection control practices. Appropriate numbers of suitably skilled staff were available to meet people's needs. Accident and incidents were recorded and acted upon. Any lessons learnt were used as opportunities to improve the quality of service

Staff had the knowledge and experience to support people's needs. They were supported through induction, training and supervision to ensure they performed their roles effectively. Assessments were carried out to ensure people's needs could be met. People were supported to maintain good health and access healthcare services when needed. People were supported with their nutritional and hydration needs.

People's privacy, dignity and independence was promoted. People told us support workers were kind and caring. There were procedures in place to respond to complaints. The provider had investigated and responded promptly to any concerns received.

The provider worked with healthcare services and professionals to plan and deliver an effective service.

Rating at last inspection

The last rating for this service was Good (published 21 March 2017).

Why we inspected

This was a planned inspection based on previous rating.

Enforcement

We have identified breaches in relation to safeguarding service users from abuse and improper treatment, safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 21 February 2017

During a routine inspection

This inspection took place on 21 February 2017 and was announced. We gave the provider 48 hours’ notice that we would be coming. We gave notice to the provider of this inspection because we needed to be sure that someone would be available to support us with the inspection process.

The service was last inspected and rated on 19 January 2015 and was rated Good.

At this inspection we found that the service remained Good.

Paradise Independent Living currently provides personal care to 12 people living in three supporting living accommodation settings and to one person who lives in the community. The service aims to support and rehabilitate people with acquired brain injuries between the ages of 18 and over.

People told us they felt safe within their home and with the support that they received from the care staff. Care staff knew how to recognise and report abuse. The provider had systems and processes in place to ensure people were kept safe and free from harm. This included personalised risk assessments and safe recruitment procedures. People’s medicines were managed safely and staffing levels were seen to be appropriate according to the needs and requirements of the people being supported.

The provider ensured that all staff received the required training and support in order to deliver effective and high quality care. Staff received regular supervisions and appraisals. People were enabled to make their own choices and decisions in the least restrictive way possible and were offered support where required. People chose what they wanted eat and planned their own menus for the week. People decided the level of their own involvement with the preparation of their meal and where they required support. People had access to a variety of healthcare professionals and were supported by care staff where needed.

During the inspection we saw that the registered manager, compliance manager and all care staff had developed and established caring and respectful relationships with the people that they supported. Staff knew each person, their likes and dislikes, their needs and requirements and were observed to be respectful of these.

Care plans were person centred, detailed and clearly outlined the person’s background history and their care and support needs which were based on their choices and wishes. Each person had a planned activity schedule which they were supported to participate in. The service had received four complaints since the last inspection. Records confirmed that these had been dealt with according to the provider’s complaints policy. People and relatives knew who to complain to if they had any concerns or issues.

People and relatives knew the registered manager and told us that the management team was very approachable. Staff told us that they also felt supported and were able to speak with a member of the management team at any given time. The provider had a variety of systems in place that reviewed and monitored the quality of care delivered ensuring that this was never comprised.

Further information about our findings is detailed in the sections below.

Inspection carried out on 19 January 2015

During a routine inspection

We undertook an announced inspection on 19 January 2015 of Paradise Independent Living. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. A single inspector undertook the inspection.

This care service is run by a private organisation based in Enfield. The service currently provides care and support to 1 person living in their own home as well as 13 people living in four supported living schemes in Enfield.

At our last inspection on 20 December 2013 the service met the regulations inspected.

There was a registered manager in post. 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 told us they felt safe in the home. The provider had taken steps and arrangements were in place to help ensure people were protected from abuse, or the risk of abuse.

People were cared for by staff who were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences working at the service and the support they received from the registered manager.

We saw positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and staff provided prompt assistance but also encouraged and promoted people to build and retain their independent living skills.

Care support plans were person-centred, detailed and specific to each person and their needs. We saw that people’s care preferences were also reflected. People were consulted and activities reflected people’s individual interests, likes and dislikes. People were supported to follow their interests, take part in them and maintain links with the wider community.

Systems were in place to monitor and improve the quality of the service. The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Inspection carried out on 20 December 2013

During a routine inspection

One person using the service said "I like the people and the service." A relative of someone using the service told us that people were supported to live as independently as possible so that they were "as good as they can be."

Care plans were in place to help people maintain their health and safety. There were also procedures to ensure that people using the service were involved in decisions about their care and for obtaining their consent before they received care. In cases where people were not able to make a decision about their own care because of capacity the provider adhered to relevant guidance on how to work in that person's best interest.

The provider had an effective system of audits which monitored the quality of the service. There were action plans for when any problems or improvements were identified. There were also effective systems for selecting and recruiting suitably qualified members of staff. Staff qualifications were checked and staff engaged in regular training to keep their skills up to date.

People who used the service were protected from the risk of abuse, because the provider took reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff could describe what might constitute abuse and were aware of the provider's safeguarding and whistleblowing policies. Staff engaged people using the service in discussions about the risks of abuse so that they could communicate problems if they arose.

Inspection carried out on 8 January 2013

During a routine inspection

As part of this inspection we visited three supported living schemes and spoke with people who lived there and who received support from staff employed by the agency. People told us that staff were kind and respected their privacy. One person commented, �the staff talk to you with respect. They keep things private.�

People told us that their individual care needs were discussed and agreed with them. They confirmed that the agency kept them informed about any issues and reviewed their care needs with them on a regular basis. Comments included, �I meet up with my key worker to talk about my support plan� and �the staff ask me if I�m OK.�

Staff had a good understanding of the needs of the people they supported and people told us that they felt safe with the staff who supported them. They told us they had no concerns about the service but felt able to talk to the manager or other staff if they needed to. One person commented, �the staff are very willing to help. They sort things out�.

People told us that they had confidence in the staff team and that staff responded to their needs appropriately. Comments about staff included, �they work well as a team,� and �staff are well trained. They do a good job.�

Comments about the quality of service provision included, �I am completely satisfied with the service given to me by Paradise Independent Living,� and �since coming to this organisation I have learnt a lot. I have become more independent and confident.�