Forget Me Not Caring Limited

About the service

Forget Me Not Caring is a domiciliary care agency registered to provide the regulated activity of personal care in supported living settings. The service currently supports 56 people with a learning disability and autistic people across 19 shared houses. People have their own tenancies and staff provide various levels of support depending upon people’s needs.

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

Right Support

Staff did not always support people to have the maximum possible choice, control and independence over their own lives. People were not always supported to make decisions following best practice in decision-making.

The provider did not always work proactively with people to plan for when they experienced periods of distress. Personalised support plans were not always in place and staff demonstrated a lack of understanding about how to support people appropriately at these times.

People were not always supported to plan and achieve their aspirations and goals. People’s care plans lacked information about what was important to them and what they wanted to achieve in the future.

Staff supported people with their medicines in a way that promoted their independence; however, the provider’s medicines processes did not always ensure people achieved the best possible health outcomes.

Staff supported people to play an active role in maintaining their own health and wellbeing, providing information and guidance about healthy eating and local sports facilities. Staff supported people to take part in a range of leisure activities in their local area.

Right Care

People’s care and support plans did not always reflect their needs and preferences or promote their wellbeing and enjoyment of life. Information was not person-centred and records were not always completed in a dignified or respectful way.

People were not always involved in planning or reviewing their own care or in making decisions about the management of risk.

Staff did not always have the necessary skills to understand people who had individual ways of communicating such as body language, sounds, Makaton [a form of sign language], and symbols.

The provider did not always ensure the systems in place protected people from the risk of poor care and abuse.

Right Culture

The ethos, values, attitudes and behaviours of the management and staff did not always ensure people led inclusive and empowered lives.

The culture of the service was not always positive and staff did not always understand best practice in relation to the wide range of strengths and needs people with a learning disability and autistic people may have.

The provider had not effectively evaluated the quality and safety of support provided to people. The monitoring systems in place were not robust and had failed to highlight concerns found during the inspection.

People and those important to them were not always actively involved in making decisions about care.

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

Rating at last inspection

The last rating for this service was good (published 15 February 2021).

Why we inspected

We received concerns in relation to the oversight of the service, staff training and understanding of people’s needs and the quality of people’s care documentation. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safeguarding, dignity and respect and oversight of the service 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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Forget Me Not Caring is a domiciliary care agency registered to provide the regulated activity of personal care in supported living settings. The service supports 41 people with a learning disability and/or autism in 14 shared houses with their own tenancies. Staff provide various levels of support to people with sleep in arrangements in place.

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

Due to people’s communication needs we were unable to talk with them on the telephone, and due to COVID 19 restrictions unable to visit them. We gathered their experiences through their family members who were very positive about the support the service provided.

Staff had the skills and knowledge to keep people safe and support was given by staff who were regular, reliable and caring.

People were safeguarded from harm as systems were in place to protect them. Risks to people were assessed and monitored. Medicine practices showed people received their medicines as prescribed. Lessons had been learnt and improvements made as a result. Staff had been safely recruited with all checks undertaken.

We looked at infection prevention and control measures. This is to provide assurance the service can respond to coronavirus and other infection outbreaks effectively. Staff carried out infection prevention and control measures to minimise the risk of infection.

People were supported to have maximum choice and control of their lives and staff and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service had a clear vision for providing high quality care and support. Quality assurance systems had been developed to monitor the service and were very well managed. People were engaged and involved; the service continuously learnt and improved as it grew and worked in partnership with other services.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture. People’s care plans were person centred and care was tailored to their individual needs, aspirations, likes and dislikes. Their lifestyle, choices and independence were encouraged and respected.

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

Rating at last inspection

The last rating for this service was Good (published 17 April 2019).

Why we inspected

We undertook this targeted inspection to check on people’s safety and wellbeing due to the increase in the number of safeguarding concerns. Also, the service is required to have a registered manager, and, at the time of the inspection, one was not in post.

We found no evidence during this inspection that people were at risk of harm. We found the manager had made an application to become the registered manager and this was being processed by CQC. The overall rating for the service has not changed following this targeted inspection and remains Good.

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Please see the safe and well led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forget Me Not Caring on our website at www.cqc.org.uk.

People’s experience of using this service:

¿ The service applied the values and principles of CQC guidance ‘Registering the Right Support’ (RRS). People were enabled to make choices about their lives and were supported to be as independent as possible. RRS guidance works to ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes including control, choice and independence.

¿ Relatives spoke positively about the service and said they felt their loved ones were safe and well supported.

¿ The service had safeguarding and whistleblowing policies and procedures in place and staff had a clear understanding of these procedures and how to keep people safe.

¿ People's needs and preferences were assessed and where risks were identified, plans were in place to manage risks safely in the least restrictive way possible.

¿ There were safe arrangements in place to manage medicines and staff followed appropriate infection control practices to prevent the spread of infections.

¿ Appropriate recruitment checks took place before staff started work.

¿ There was sufficient staff available to meet people's needs promptly and to ensure they could go out with support when they wanted.

¿ Staff had the skills, knowledge and experience to support people appropriately. Staff were appropriately supported through induction, training and regular supervision.

¿ People were supported to maintain a healthy balanced diet.

¿ 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.

¿ Relatives told us they were fully involved in and consulted about their loved one’s care and support needs.

¿ People had access to health and social care professionals as required.

¿ People were supported to access community services and to participate in activities of their choosing that met their needs.

¿ Staff worked with people to promote their rights and understood the Equality Act 2010 supporting people appropriately addressing any protected characteristics.

¿ There were systems in place to assess and monitor the quality of the service.

¿ The service worked in partnership with health and social care professionals and other organisations to plan and deliver an effective service.

¿ The service took people, their relatives and staff’s views into account through surveys and informal feedback to help drive service improvements.

Rating at last inspection: Good (Report was published on 13 July 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. We found the service continued to meet the characteristics of Good in all areas.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

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

The service has 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.

People were safeguarded from the potential of harm and their freedoms protected. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff had received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care. The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance were sought from health care professionals, including GPs. People were supported with their nutrition and hydration needs. Staff supported people with their medication as required.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. Staff were attentive to people's needs and treated people with dignity and respect.

People were supported with activities which interested them. People and their representatives knew how to make a complaint; complaints had been resolved efficiently and quickly.

The manager had a number of ways of gathering people’s views including talking with people, staff, and relatives. They carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.