Archived: The Crescent

At our last inspection on 8 September 2016 we found improvements were needed in how incidents which had occurred were recorded and reported and how action was taken to prevent further incidents. At this inspection we found the provider had made the required improvements.

This service provides care and support to people living in eight ‘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.

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 were protected from abuse and risks were assessed and planned for to keep people safe. Premises and equipment were maintained to minimise the risk of infection. People were supported by sufficient safely recruited staff. Medicines were managed and administered safely. The registered manager had systems in place to learn when things went wrong.

People’s needs were assessed and effective care plans were in place. Staff received training to support people with effective and consistent care. People were able to choose what they had to eat and drink and were supported safely. People had support to maintain their health and wellbeing. 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 supported this practice.

People were supported by staff that were kind and caring and had good relationships with people. People had their communication needs assessed and care plans were in place which supported people to make choices and retain their independence. People were treated with dignity and respect.

People’s preferences were understood by staff, assessments and care plans considered diverse needs and how to meet them. Reviews of people’s care needs were undertaken and people were supported to follow their interests. People could make a complaint and there was a system in place to investigate these. People had their wishes for end of life care considered.

People and their relatives were involved in the service and were asked for feedback. We found systems in place to check on the quality of the service people received and the provider used information from these to make improvements. The registered manager had systems in place to monitor the delivery of people’s care.

The service provides personal care for up to eight people with a learning disability in their own homes. At the time of the inspection eight people were using the service.

There was 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.

At this inspection we found that some improvements had been made in the areas of concern and the provider was no longer in breach of any Regulations of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However further improvements were still required to ensure people received safe, effective, responsive and well-led care.

We found that incidents were not always reported in accordance with the provider’s policies and procedures, and the management team had not identified this through their audit systems which showed some audits were ineffective.

People's risks were assessed and managed to help keep people safe. There were enough staff to meet people's needs. People told us and we saw that requests for support were responded to promptly by staff.

People’s medicines were stored and managed safely, and staff understood and acted on any signs that may indicate that people were unwell.

Staff were suitably trained to meet people's needs and were supported and supervised in order to deliver care to people effectively. Staff understood how to support people to make decisions and when they were unable to do this, support was provided in line with the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drink and were provided with support when required to ensure their nutritional needs were met.

People's health was monitored and access to healthcare professionals was arranged when required.

People were treated with kindness and compassion and were encouraged to make choices about their care and how they wanted to spend their time, and their privacy and dignity was respected.

Relatives and staff felt the registered manager was approachable.